Flovent (Fluticasone Propionate)

This is what you have to do sometimes

For those of you have have heard of, gave advice about, or lent a ear to my medical woes over the past 6 months, I want you to know my stubbornness has really come through for me. Or maybe the right word is tenacious.

I literally, physically, walked into Care 1st's (my health insurance company) corporate office and asked to talk to someone in pharmacy. Pharmacy is the department who approves/denies medications. When you call in, the Care 1st agents will not let you talk to them. They asked my name, and I said "Crystal", they asked who I wanted to see, and I said "I just need to turn in some paper work." I stayed smiley and very polite even though inside I was angry and nervous all at once.

A woman from pharmacy came out. I asked her if she had an office; she said we could stay right there.

I said, "Here." and handed her a letter, my denial letters from Care 1st, a copy of my medical records, a request for medication from my primary care physician, and a personal letter from my primary care physician explaining the need for my medication.

She said she would look over it, and started to stand out of her chair. I put a hand on her arm, she looked at me, I said "Stop. Read this letter."

This is the letter I wrote:

PCP: Primary Care Physician Dr. Elliot Blau
Phone: 480 947 ****
The insured: Crystal Marston ID # A686***** 001

November 08
-The insured’s first appointment with PCP prescribed: Singulair and Advair due to poor asthma management on current medication
-Medication denied: Advair and Singulair
-First denial: At Pharmacy
-Action taken: The insured called Care 1st. Care 1st agent requested medical records that proved the insured had taken the medication Flovent for three months or more, and failed on that medication, prior to approving Singulair or Advair.

January 09
-Action taken: The insured signed a medical release for prior...

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