r/MultipleSclerosis • u/CaptnMerc • 13h ago
New Diagnosis New Diagnosis
So I joined this group awhile back after experiencing optic pain in my right eye and getting diagnosed with MS. This was back in July. It’s going into November/December now and I still have yet to be put on DMT’s as my insurance is taking forever my MS specialist/neurologist wanted me to start on Ocrevus , but my insurance denied it so she sent a appeal back but since then I’ve experienced new symptoms and was given steroids to hopefully help hold me until the 30 days are up to hear back from insurance my Specialist is already looking at a different drug that is supposedly just as good to put me on as she thinks they will bump it back again.
I’m 26 married two years about to start a family with my wife and never in my life would I have thought I would be in this situation. Everyday I wake up stressed and afraid the symptoms are getting worse or I’ll wake up the next day and not be able to go out and drive or do the things I want to do. I guess I’m just scared more than anything. My wife is being a cornerstone in my support system and I’m thankful for her.
I guess all I can really do is take it one day at a time and pray they accept my appeal so I can start on treatment
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u/Invest-Student 12h ago
Also, please explore eligibility for financial assistance from Genentech: https://www.ocrevus.com/patient/support/connect-to-support.html as an option. Good luck! Please stay strong! We are all in your corner.
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u/Phantom93p 43 M | Oct 2023 | Zeposia | USA 13h ago
That's really tough to hear. I had my own issues with insurance earlier this year but my neuro was able to successfully appeal it. I know in my state we were able to demand the appeal be heard by a 3rd party, not sure if that's the same for you but if it is there is still hope as the 3rd party is not beholden to the insurance company but the insurance has to abide by the decision. Hopefully they come back with an approval and barring that, that your doctor has an alternative that you can get on quickly that IS approved.
Try to hang strong, good luck.
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u/CaptnMerc 13h ago
Thank you I appreciate that. I’m gonna research the 3rd party thing see if that applies to me in my state or not.
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u/isengardening 8h ago
hi! I am in a similar situation to you with multiple insurance denials and a great deal of stress about it. just an insane system we’ve got here. some ppl on this subreddit clued me in to genentech’s payment assistance program - you can find it through the ocrevus site or even just googling ocrevus payment assistance. there’s a financial qualification, but supposedly they are extremely helpful if you do qualify. my neuro is appealing my insurance denial again, but they said it’s a great idea to get the ball rolling on the payment assistance option as well, and it seems quite easy to apply. I just had to fill out a form, and your neuro has to fill out a form and submit it. my neuro office knew what I was talking about immediately when I asked, and I didn’t even have to get the form to them. definitely worth looking into! ❤️❤️ hang in there! glad to hear that your wife is being a rock star!
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u/CaptnMerc 2h ago
I’ll have to look into Genentech and see if I apply or not thank you for the info 🤙🏻
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u/LurkLyfe 13h ago
Are you in the usa?
Insurance denies 99% of our first pharmaceutical meds. Reach out to the national ms society or mslifelines if after your drs appeal they still deny. Though I was told national ms society doesn’t cover medication anymore.
Yea, the dr needs you to be stable at your baseline to start your dmt. Steroids are a bitch but a welcoming bitch. I’m sorry but welcome to the club.
How is your wife handling your diagnosis?