Faces in the Crowd
The NHF asked its Facebook community how insurance coverage impacts their medication usage and received some passionate testimonials . Here ’ s what you had to say :
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My insurance These insurance
Insurance only has denied multiple preventives the approvals tablets of Imi- people who do allows me nine for me . They have never had
trex or Zomig a say the medication is not a migraine .” month , which is not nearly intended for migraines — no – Cheryl W . enough when I have a crap — there really is not migraine every day . So I much that IS developed have to try to ration my meds , I have to ask myself for migraines . They need to be more accommodating with off-label use . It ’ s a lot less expensive than inpatient treatment .” – Katie M .
meds for the worst headaches . This goes against what you should do .” – Patsy C .
I don ’ t have insurance because I had to stop teaching due to my persistent daily migraines . Every time I need one of my rescue
if the pain is at a high enough level to deserve the expense .” – Sarah J . are generally covered through medical benefits . To make matters even more confusing , some medications given to migraineurs in the emergency room or in-office may be covered through medical benefits , not pharmaceutical .
Patrick-Lake learned of these classifications first hand after undergoing Botox treatments for her chronic migraines . Her insurance provider covered the $ 500 injection procedure fee , but the $ 1,500 drug got billed in an area of coverage that had a separate deductible , Patrick- Lake says .
2 . Get to know your doctor
Headache patients need a physician who can do more than just diagnose and treat their illness ; they need a true partner in care . Tackling both chronic pain and insurance authorizations demands a team effort .
“ It ’ s about finding the headache specialist who will go to bat for you ,” Patrick-Lake says .
Once you have located the right healer ( chosen from a list of in-network doctors ), it ’ s important to get involved in the continuum of care , from diagnosis to follow-ups . A good place to start is where many migraine and headache sufferers square off with their benefit companies — over the prescription medications used to treat their conditions . Some patients find name-brand drugs more effective than their generic counterparts , while others don ’ t get enough triptans to cover all of the migraine attacks they experience in a month . In these cases , patients can find themselves digging deeper into their pockets — sometimes to the tune of hundreds of dollars per month — for drugs their payers won ’ t approve .
Merle L . Diamond , MD , headache specialist and president of the Diamond Headache Clinic in Chicago , says it ’ s unfair to penalize patients who don ’ t want to take generic drugs that might not work as well .
Tackling both chronic pain and insurance authorizations demands a team effort .
www . headwisemag . org | National Headache Foundation 37