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Medicare

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  1. I've used Part D since 2006 and my med list has decreased to just 2. I evaluate policies yearly and end up choosing a new company each year. Today I wonder if I can survive their games. I resolve nothing between the Dr and insurance company.

    I've used Provigil since 6/2000. Ins denied it but covered it's generic Nuvigil instead, which I've used since 1/2012. Each year we met the prior approval with the policy. This company has denied Nuvigil twice and Provigil once, so far. I am paying out-of-pocket for Nuvigil every few days, in hope of approval. These drugs are often used as an anti-fatigue due to multiple sclerosis, but it is as an off-label use. I am concerned over my financial and physical costs. I saw new mental limitations from the beginning.

    How do I address this in a helpful way? Venting feels good. My story is minor, but with an elder unaware, and a critical medicine, it could evolve into a lost of life. MS does poorly with excess stress and I am proof of that.

    1. I had hoped with the release of generic modafinil, it would loosen up the insurance companies' routine refusal of this off label use. By any chance have you had a sleep study done? I have mild sleep apnea and my nejurologist was able to use that to justify my prescription for Provigil.

      I hope you can find a way to get them to cover this drug - for many of us it make a serious difference.

      1. Sleep study was mentioned but my dance card is nearly full. I may go that way. I keep angry due to principle .

        1. Heard from neuro office: it's no go w/ins. Offered Ritalin which I refused. Can see if manufacturer can assist me to buy nuvigil, but that's not 1st choice. I mentioned sleep study but they weren't optimistic of it. I'm checking into a new ins policy. I'll check further to their approved uses of nuvigil before I buy. I will contact Medicare, etc., about that issue. I worry it is becoming more common due to economy.

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