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The English Guy

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  1. The English Guy

    New, English and Confused .

    Hi All, I am an English Guy living in ND (please don't ask it is a long story) , I have only had Cluster Headaches for a couple of years now, mostly in a 6 month cycle starting around April. I went through what appears to be the usual BS with my then Doctor, stating it was a Sinus infection and "why aren't these antibiotics working?? " , I changed Doctors and thankfully they knew straight away what we were dealing with. So Sumatriptan was prescribed which works well for me, can clear up an episode in about 10 mins, then my Pharmacist found out about Emgality ... fantastic ! My Doctor was on board, prescribed it immediately, and then guess what , my insurance Blue Cross Blue Shield denied the claim, they also denied refills on the Sumatriptan stating I didn't need more than 6 every 2 weeks, well at 2 episodes a day 6 lasts 3 days not 14 so for 11 days I have zero medication I can take unless I can find $300 for 6 nasal sprays ! BCBS are denying all attempts to get them to pay for the medication, (even though I hit my deductible some months ago), on the basis that it is Migraine medication, and I do not suffer from Migraines !! Has anybody else had this issue with their insurance company ? is there a way around it ? By denying my claim it just feels like legalized torture, or at the very least a human right violation, surely this has to be illegal ?