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I am currently on gamaguard infusions every other week. I also take mestidon daily 75mg, 8am,12pm,4pm,8pm and I wake up at 4am and take 60mg

A MGteam Member asked a question 💭
Michigan, Wyandotte

But I am still having minor speech difficulties and eye lid issues and constantly tired. The Doctor wants to change my infusion to rystiggo but BCBS insurance says that I have not tried other medication. They gave me a list of 10 different medications and all have high risks of different types of cancers
I already have had cancer twice, prostate and my prorotted gland
( my jaw) BCBS refuses to change my infusion until I try one of those
I don’t want cancer again what can I do. BCBS has refused… read more

August 4
 · 
Be the first to react
A MGteam Member

My insurance also denied my prescription for rystiggo, and denied my 2 appeals. They did approve me after 3rd letter from Dr. But it took 6 months and an mg crisis. The rystiggo infusions have changed my life, and if you are not on government insurance, the rystiggo co. helps with the cost. Good luck.

August 5
MGteam

What can you do when insurance keeps denying your doctor's recommended treatment, especially given your cancer history? This is such a frustrating situation, and your concerns are completely valid.

Here are some steps worth exploring:

- Request a formal appeal — BCBS must have an appeals process. Your doctor can submit a Show Full Answer

What can you do when insurance keeps denying your doctor's recommended treatment, especially given your cancer history? This is such a frustrating situation, and your concerns are completely valid.

Here are some steps worth exploring:

- Request a formal appeal — BCBS must have an appeals process. Your doctor can submit a detailed letter explaining why those 10 medications are medically inappropriate given your cancer history
- Ask for a "medical necessity exception" — Your doctor can document that the listed medications pose unacceptable cancer risks specific to your situation
- Request peer-to-peer review — Your doctor can speak directly with BCBS's medical reviewer, which sometimes changes outcomes
- Contact your state's Insurance Commissioner — They can intervene when insurers deny medically necessary care
- Ask about external independent review — You have the right to request an independent medical review of the denial
- Consult a patient advocate — Hospital social workers or nonprofit patient advocacy organizations can help navigate insurance battles The Myasthenia Gravis Foundation of America (MGFA) also has resources to help with insurance disputes and can sometimes support appeals. Given your history, your doctor's documentation of prior cancers is a powerful tool in fighting this denial. Don't give up — two denials doesn't mean the final answer is no.

August 4

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