Cigna Health Spring & compounded med coverage

Discuss different Pain Management Options; Medication options including side effects and Worldwide variances in names etc.
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quilter
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Joined: Wed Mar 09, 2011 10:27 pm

Cigna Health Spring & compounded med coverage

Post by quilter »

I'm a new Cigna Health Spring subscriber this year. Thought I'd try to see if they'd give a little financial help for my 2 compounds (Valium/Baclofen suppositories, and LidocaineBupivicaine ointment). My doctor submitted the requests for coverage determination. I've already spent 2 hours on the phone this week with multiple people, and so far they'll only authorize the bupivicaine.

Since Cigna is a national prescription plan through Medicare, has anybody had luck getting coverage for compounds, or am I unneccessarily raising my time and lood presssure talking to people who don't understand? Several "clerks" at Cigna couldn't even read the script correctly or understand that each product contains 2 drugs -
had to explain that concept repeatedly. Because of multiple chemical allergies (and these items are used on mucous membranes) I can't have anything with fragrance, dye, etc. They must be compounded in a neutral base, and each script is about $150 cash.
Acute left vag/rectal pain 1999 lowering into chair. Dx 2006 with PNE/VV by PTs, Dr. Garcia, Weiss, Hibner. Many shots. PNMLT: left PN barely fuctional. Left TIG by Dr. Hibner 2007 (ST lig). 75% improved 1 year postop, slow decline. Pelvic floor Botox 2010. Left sacral SCS 2011 after good trial; removed 2012 due to NEW left S2 & rectal pain, bowel freq. Re-do left TIG by Dr. H & 5-day ketamine 2013; 1-1/2 years postop 70% improved. New post-SCS Sx are worse than PN Sx.
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Violet M
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Re: Cigna Health Spring & compounded med coverage

Post by Violet M »

Eeeek, that is expensive. I haven't had experience with Cigna on drugs but when I had my PNE surgery they did not cover it -- even though I went up through all of the appeal levels. There was no amount of discussion or logic that would change their minds. I'm sorry, Quilter. I understand how frustrating it is.
PNE since 2002. Started from weightlifting. PNE surgery from Dr. Bautrant, Oct 2004. Pain now is usually a 0 and I can sit for hours on certain chairs. No longer take medication for PNE. Can work full time and do "The Firm" exercise program. 99% cured from PGAD. PNE surgery was right for me but it might not be for you. Do your research.
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