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California - Lifetime Med - Coverage Terminated
(01-23-2019, 01:36 PM)1171 Wrote:
(01-23-2019, 10:55 AM)spine pain Wrote: Where to start - California Workman's Comp- settled with lifetime medical in 2000. They initially covered my pain management procedures - then after a few years, it became a nightmare to get covered. They have been covering my medications until this month. Without notice, they stopped covering the opiods that I have been taking for 15 years.

Can they do this without any notice? I am not working and in the process of going on SSDI, due to the issues I am having with my health, related to this injury. I do not know where to tuen on this. I do not live in California anymore, so I do not know where to turn.

Thanks for any advice that can be provided

Treatment approvals and the documentations are handled between the physician & the carrier, generally the patient is not part of that correspondence. I suspect a recent update to the drug formulary was not adequately addressed by your treating physician.
The formularies are here
You should contact your doctor about getting preapprovals from the carrier for
The highly controlled long time use of opioids. The treatment guidelines do allow for a surpervised plan to reduce patient dependencies on opioids.

I think this is the issue - both of meds are non exempt. Like I mentioned in the other thread, UA has been an absolute nightmare. I called the adjuster and they mentioned that they would gladly settle the lifetime, if I would like. Timing is just really bad.
I have been compliant on the use of the meds and I have even reduced down to the CDC guidelines. My injury is one that I will have pain the rest of my life.

Messages In This Thread
RE: California - Lifetime Med - Coverage Terminated - spine pain - 02-18-2019, 02:03 PM

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