Rejection letter from Janssen CarePath re Spravato

Posted by Shirley Hugh-Jesst @audriana, Sep 1, 2021

Dated 8/25/21 I received a rejection letter from Janssen Care-path Savings program…
ineligible…due to:
X. You currently do not have commercial or private health insurance…this program is not available to individuals who use any state or federal government-funded Healthcare program…"
Ironically, I do have State Employees Health plan, plus Medicare & Tricare…so much insurance and yet so many obstacles. The image of the letter isn't clear, so don't worry about it. It just says, "blah, blah, blah, blah-blah."

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Hi @audriana, form letters are usually short on details and not personal. It gets so exhausting to continue to advocate for yourself, but I'm afraid that's what you might have to do … again. I read in your bio that you are an advocate and an educator, so I know you can do this. Can you contact a Janssen CarePath Care Coordinator and explain your insurance status? Clearly they don't have the correct information.

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@audriana I received the same confusing letter. It just means you don't qualify for payment assistance for the medicine. You already have your own insurance, thus you don't qualify for their assistance program. NC State Employees /Medicare/ Humana covered my Spravato, no problem..

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@clutch @colleenyoung hi! I took the letter to my psych appointment today. We mutually rolled our eyes because it was so confusing.. We figured it was something automatically processed. As @colleenyoung said, form letters are not personal.
Clutch–you mentioned Humana…smh…I was told by Humana that Spravato was not in the 2021 formulary, so I opted for BCBS 70/30…another complication.
Onward and upward! Thanks for the info and support…
6:35 pm, I just got off the phone with Andrew. Today, he spent 3 hours working with the insurance companies. BTW, he confirmed that Spravato is in Humana's formulary now.
Last week, I was on the phone with Medicare for an hour and 58 minutes…whew…yes, advocating is indeed necessary
Sometimes it's just really difficult when my brain is malfunctioning…

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@colleenyoung

Hi @audriana, form letters are usually short on details and not personal. It gets so exhausting to continue to advocate for yourself, but I'm afraid that's what you might have to do … again. I read in your bio that you are an advocate and an educator, so I know you can do this. Can you contact a Janssen CarePath Care Coordinator and explain your insurance status? Clearly they don't have the correct information.

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@colleenyoung, you're absolutely correct. The information was inaccurate–so many glitches. A woman from Janssen–Veronica–is supposed to contact me.Apparently, even she is confused as to what is going on with my case. I have people in my corner and I appreciate their efforts.

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@audriana

@colleenyoung, you're absolutely correct. The information was inaccurate–so many glitches. A woman from Janssen–Veronica–is supposed to contact me.Apparently, even she is confused as to what is going on with my case. I have people in my corner and I appreciate their efforts.

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Best of luck, Shirley. Sending you patience and fortitude to keep at it until you get answers. It's not easy being a patient.

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I know Spravato is more expensive. I found a provider that does ketamine treatments which are less than half the cost but still not covered by insurance. Just FYI. I am feeling some relief as I am still in the initial phase of treatment.

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Hello everyone. I kind of fell off the face of the Earth for a while. I'm sure some of you can relate…nothing major or drastic happened. My garden is flourishing and I will, too, soon. I have kept up with my neighborhood advocacy group, Bows of Hope ( really cool, positive Facebook group) and getting my home in order. When I am in a "good" mood, I'd rather do something creative then "clean."
I am resuming Spravato–esketamine treatments, starting 11/10/20:
Wednesdays & Fridays for 4 weeks.
Then once a week for a month.
Then once every other week until I reach maintenance again.
My last treatment in March, 2019, lasted for 5 months…then I renewed my contract: My Unsuicide Note on 8/20/2020.
My psychiatrist asked me. "Are you still cautiously optimistic about Spravato?"
I know that I responded well with Spravato, in conjunction with taking advantage of my "Awakening."
Body, mind, & soul combo, please.
I'm concerned about logistics, but I am focusing on
"Hope is the joyful expectation of good things to come."… and knowing I cannot control everything. This year, I had a revelation about the significant impact anxiety has had on my life.
So, I think I'm in a good place.
If you're interested, I will keep you posted on my progress.
Sharing, teaching, interacting…positive strategies for me.
Wish me well.
Thanks for allowing me to participate in this group. ☮
BTW…if you want to express a simple gesture of thanks to those who have stayed the course during COVID, display or give a bow:
White: Healthcare
Yellow: Military deployed to COVID Hotspots in our nation
Red: Fire and Rescue
Blue: Law enforcement
Green: Essential personnel & humanity

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@audriana

Hello everyone. I kind of fell off the face of the Earth for a while. I'm sure some of you can relate…nothing major or drastic happened. My garden is flourishing and I will, too, soon. I have kept up with my neighborhood advocacy group, Bows of Hope ( really cool, positive Facebook group) and getting my home in order. When I am in a "good" mood, I'd rather do something creative then "clean."
I am resuming Spravato–esketamine treatments, starting 11/10/20:
Wednesdays & Fridays for 4 weeks.
Then once a week for a month.
Then once every other week until I reach maintenance again.
My last treatment in March, 2019, lasted for 5 months…then I renewed my contract: My Unsuicide Note on 8/20/2020.
My psychiatrist asked me. "Are you still cautiously optimistic about Spravato?"
I know that I responded well with Spravato, in conjunction with taking advantage of my "Awakening."
Body, mind, & soul combo, please.
I'm concerned about logistics, but I am focusing on
"Hope is the joyful expectation of good things to come."… and knowing I cannot control everything. This year, I had a revelation about the significant impact anxiety has had on my life.
So, I think I'm in a good place.
If you're interested, I will keep you posted on my progress.
Sharing, teaching, interacting…positive strategies for me.
Wish me well.
Thanks for allowing me to participate in this group. ☮
BTW…if you want to express a simple gesture of thanks to those who have stayed the course during COVID, display or give a bow:
White: Healthcare
Yellow: Military deployed to COVID Hotspots in our nation
Red: Fire and Rescue
Blue: Law enforcement
Green: Essential personnel & humanity

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@audriana welcome back! I wanted to let you know that I moved your post back into an existing discussion you started on Spravato to give those members following/participating an easier way to find and read your update. It is great to hear that you feel you are in a good place. Hope is a powerful emotion!

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@audriana

Hello everyone. I kind of fell off the face of the Earth for a while. I'm sure some of you can relate…nothing major or drastic happened. My garden is flourishing and I will, too, soon. I have kept up with my neighborhood advocacy group, Bows of Hope ( really cool, positive Facebook group) and getting my home in order. When I am in a "good" mood, I'd rather do something creative then "clean."
I am resuming Spravato–esketamine treatments, starting 11/10/20:
Wednesdays & Fridays for 4 weeks.
Then once a week for a month.
Then once every other week until I reach maintenance again.
My last treatment in March, 2019, lasted for 5 months…then I renewed my contract: My Unsuicide Note on 8/20/2020.
My psychiatrist asked me. "Are you still cautiously optimistic about Spravato?"
I know that I responded well with Spravato, in conjunction with taking advantage of my "Awakening."
Body, mind, & soul combo, please.
I'm concerned about logistics, but I am focusing on
"Hope is the joyful expectation of good things to come."… and knowing I cannot control everything. This year, I had a revelation about the significant impact anxiety has had on my life.
So, I think I'm in a good place.
If you're interested, I will keep you posted on my progress.
Sharing, teaching, interacting…positive strategies for me.
Wish me well.
Thanks for allowing me to participate in this group. ☮
BTW…if you want to express a simple gesture of thanks to those who have stayed the course during COVID, display or give a bow:
White: Healthcare
Yellow: Military deployed to COVID Hotspots in our nation
Red: Fire and Rescue
Blue: Law enforcement
Green: Essential personnel & humanity

Jump to this post

Hello @audriana,
I am glad you are back! And that you have negotiated the course in finding a Spravato provider. Hope that the road continues well with you to better health. Are you traveling to the Benson Clinic for treatments, @audriana?

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@clutch

Hello @audriana,
I am glad you are back! And that you have negotiated the course in finding a Spravato provider. Hope that the road continues well with you to better health. Are you traveling to the Benson Clinic for treatments, @audriana?

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Hello @clutch Yes, I will be going to ECMC. in Benson…51 miles one way.. You were instrumental in me not giving up.. I am worthy of the expense & inconveniences to get appropriate, effective treatment. Thanks for your kind, direct advice.

Dr.Vyas is the supervising physician. Andrew is the Pharmacist and will be monitoring my treatment. I met everyone on 11/4/21.
How are you? I hope you are well.

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