We have a potentially very serious medication issue with Gavin. Today we received another denial letter from his insurance company. This time it was about his antipsychotic medication, Clozapine. They are refusing to pay for his prescription because his dosage is higher than the FDA approved amount.
I’m not sure how we are going to address this.
The only reason this is even an issue is because Ohio has forced everyone on disability, to choose an HMO provider and transition from straight Medicaid.
What we need to find out, is whether or not this denial was sent before or after the attempt at a medical override.
This is a very serious problem because Gavin has less than a days worth this medication left. If this gets messed up, it’s a really, really bad thing. The biggest problem is that if the Clozapine stops working, we have nothing left to treat his Schizoaffective Disorder.
My priority for Wednesday is to get this straightened out before anything gets worse.
I’ll be very honest with you and say that I’m pretty nervous about this. We have to get this fixed tomorrow, we have to.
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