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Health Insurance Companies lack of compassion
6 Replies

My doctor and I decided to add Cymbalta to my current medication. I suffer from progressing pain and fatigue. The pain is very severe in my lower back and the rest of my body is painful as well. I am so tired after work that I just want to lay down and sleep. When I cannot since I have a child to care for.

And I have never asked for any compassion or pity. I will admit that I have alredy had plenty of pity parties myself, but do not expect them nor care for them half the time.

When I get to the pharmacy, I receive a pc of paper stating my insurance has denied my coverage for this medication. Guess they do not believe I would benefit. I have to prove what condition I have that this drug can treat, and also what other meds in that class I have tried. It is absolutely insane! I cannot keep up with all the steps of what I need to do.

I did call my doc and they said they have something similiar for me to try. When I get it I will post the name. But that isn't the point. Why can't I try the drug that has been approved to help Fibro patients and new studies also show may help with patients with chronic back pain?

I am sorry, I had to vent to someone and thought ppl on this forum would understand.

We have too much on our plate with pain, fatigue, sleep deprivation, fibrfog and the list goes on, to have to deal with insurance companies telling us they will not pay for something our doctors think we should try.

Thanks for listening.


Cher0208 - March 30


Sorry to hear that you are going through that. I live in New York and opted to continue my health insurance after I switched jobs and my current job does not offer health insurance. So my Cobra payments have been $642 a month and I pay a co pay of $50 for every specialist appointment I go to. If I decided to pay for private ins. it would be well over a thousand dollars for just myself. I'm going deeper into debt just to take care of myself.

I was also on birth control for many years and just got off of it thank God. But the point is they wouldn't give me the name brand, only the generic. Which is a lot less consistent in its formula and obviously a bad thing when you're talking about not getting the same dose of hormones every month. Anyway, I feel your pain with health insurance. Too bad we don't live in France. We wouldn't be dealing with health insurance! Good luck. Just fill out the stupid papers and be persistent and they will approve you for the med you want to try.





Thanks for responding to my post. I was so frustrated about this. I am going to just do what needs to be done so I can try this med. Again, I just do not understand why they can make decisions for us. While we pay monthly! That is a LOT Of money you are paying. I thought my 440 a month was a lot.

Hang in there as well. We will get through this together. The heck with the insurance companies! lol

Have a good day...

Lots of pain and VERY tired today.. HOpe I make it through the day at work :)


Gentle hugs


Fantod - March 30

I completely understand how you feel. If you are employed, the fault lies with your employer. They chose this type of healthcare plan to hold down costs. You will have to try every other medication that may work in lieu of Cymbalata until all options have been exhausted. Only then, will they give you Cymbalata.

Your doctor is not a secretary. It is their job to figure out what medication may work best for your situation. And, the health insurer is not in the room when the choice made. It is unfortunate that they get to meddle in your health needs and that your doctor has to second guess his decision and probably write letters or fill out endless forms on your behalf. It seems to me that we all have better things to do with our time.

You should have been provided a formulary which would tell you what medications are covered under the plan. If you can get a copy, that would save some time and may help your doctor figure out a way to circumvent this nonsense.

Your insurance company must have a way to appeal these types of decisions. Yes, I know that anyone who is chronically ill should not have to deal with this crap. But, if you don't fight for yourself, no one else can or is going to do it.

The squeaky wheel is the one that gets the grease. I dealt with a similar situation quite a few years ago. I have a friend who has FMS, RA and Sjogren's. She had a similar healthcare plan and could not get the medication that her doctor wanted her to use. I commandeered her health care insurance information and made a nusisance of myself until someone finally listened to me. It took me about ten days of constant phone calls and arguing but I managed to get her what she needed. In retrospect, they probably gave her the medication so I would stop calling - lol.

I have severe lower back pain too. I have degenerative disc disease and stenosis. I take Cymbalata which has helped with my overall pain levels. You could try Curamin which you can find online or if you have a good local healthfood store. This is a spice which has been highly purified for this application and comes in capsules. It is very good for pain. I use it everyday for breakthrough pain. A key point to remember is no matter what you do, it is going to take some time before you notice a change. The longer a chronic pain cycle continues, tha harder it becomes to manage or stop.

Also, Tiger Balm makes a pain patch which I like too. The Vitamin Shoppe usually has them in stock. The patch does smell a bit but it is pretty effective.

Try not to let the bast**ds get you down. I'm glad that you decided to vent rather than dwell on the problem. More heads are always better than one. Feel better and take care.


kvc33 - April 1

Insurance companies, like any other, are in it to make money. You really can't expect 'compassion' for them. In Canada we don't have to deal with any of this. The government pays for most of our medical care whether we are poor or comfortable.


January - April 1

Well, this is a wild idea, and I don't know if it fits into your situation…. but what about all those programs the drug companies run that go "If you cannot afford your prescription….. " Supposedly, they have programs that will help you get the drugs at low or no cost?

Have you tried calling the company that makes Cymbalta to see if they will fight for you?


January - April 1

YESSS!! I just googled "Cymbalta help paying for…"and up came a lot of results. Please try this! I believe the drug company is Lilly - and "they care." See what they will do for you!

Good luck with it!



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