I have lived N for the past 8 years. I started with Provigil and moved to Nuvigil 12 months ago. My dosage has been 500mg Nuvigil (2 tabs of 250mg) a day. The 500mg dosage of Nuvigil combined with 20mg of Celexa ( for cataplexy) and a healthy lifestyle allows me to live a "normal" life. I just switched to AETNA insurance with my new employer and Aetna DENIED the prescribed dosage to only approve250mg a day. My doctor appealed and was turned down. I am writting an appeal to Aetna, but I have very little faith of a positive outcome.
IF denied, I will go to the courts in the hope that the courts will oblige Aetna to accept the dosage. Has Anyone ran into a similar experience that can provide me with some advice?
Are there standard appeal letters I can use to file my appeal? What supporting document should I include?
I consider Aetna's behavior to be CRIMINAL. Aetna knows that I can get into an accidentat any time and seriously hurt myself and others, but they still deny me the meds. There is something wrong with our Healthcare system and Justice system where minors are sent to jail for stealing snicker bars and insurance companies are free to commit 2nd degree murders.
I welcome your input and advice to get through this situation.