Don’t know what to do anymore for 12 PA from Physician

I was sent here by the spouse with a throw-away account. I was told I can get some opinions about how I may rectify this.

I’ve had RA and Fibro for 21 years and have been an LPN for 20 years. I work more than I can bear with my problems and often can be difficult with an insufferable amount of pain. My insurance provider Anthem through BCBS is not approving my norco medication despite my provider signing a 12 month pre-auth. Every month I argue with Anthem trying to get them to push it through, but more and more frequently they keep saying “we need more information from the provider”. Anthem will not approve the norco and I am in so much pain, I am so tired of this insurance. My norco is as-needed and I can generally make a bottle last 1.5 months before I am dry, biut assuming I get my infusion at the beginning of the month, I can do pretty well without it. It’s generally a week or two before my next infusion where I begin to suffer with pain. Salon pas patches, hot rice bags and a bottle of advil nearly each week helps but is only temporary.

I don’t know what to do anymore, it’s going to kill me. Every month I have my RA bag mailed to me in a cooler to which I store in the fridge, I have been through 12 trials, and allergic to most of the infusions that insurance has requested to go through. Now, they want me to start all over with the trials; I think 17 years of trials is enough after finding something that works with me.

Anthem only does business with CVS and won’t mail my norco, because it’s controlled. I have emailed and called my primary at the RA/Fibro facility and he says there is nothing he can do, all he can do is keep resubmitting the 12 month PA, but the insurance keeps giving him grief as well.

Is there anything I can do to expedite this, I have been 2 weeks without norco now and I can’t keep calling out of work due to the pain. I don’t mind paying out of pocket, outside of insurance, but I don’t want to set off any red flags because I know they are cracking on opiod usage with dealers and abusers, but my charts, trials and history show I am not one of those people.

I believe I have chosen the correct flair for this topic, if not I am sorry.