What part of "he needs them" do they not get?

[ElleGee]

As of Feb 1st my insurance doesn't cover name brand drugs.. Concerta does not come in generic form..

My doc had to send a fax to my insurance telling them that this is the best treatment for him and there is no generic form and he needs it.

Today I go and get the script filled and my insurance kicked it back..

WTF..

Concerta is NOT cheap. I cannot afford it.. and he took his last pill this morning.. So my doc has to resubmit the paperwork to get the authorization again... and it's not a quick process.. Which is why he sent the paperwork in before the new rule came into effect.. I should have had a preauthorization already

I doubt my doc screwed up.. It's not like him . I am pretty damned sure it's my insurance.. I HATE the fact I had to go back on this one because United screwed my Primary doc and he won't accept it anymore.. It's not the first time they have screwed up major like..

I have been on the phone all day and now I have a headache ARGH!!!!

[socks1211]

aww man that suck
i hope you can get it all worked out

[Kelsey1224]

I'm so sorry. That sounds like a major pain.

[Urban Cowgirl]

In the meantime call and ask his Dr if you can get samples to hold him over until this mess is taken care of.

[kelblend]

Hope he's able to get authorization. I remember having to go around and around a couple times with United.

[LitWtch]

Elle - if it is the 18 mg or less, there are free offers in the family type mags. It is good once per year, but can get you through until you get insurance straightened out. I have one here that has already been activated if you want it. PM me with your address if you do and I will get it in the mail by weeks end. We could not use it because DD is on 27 mg.

[ElleGee]

Elle - if it is the 18 mg or less, there are free offers in the family type mags. It is good once per year, but can get you through until you get insurance straightened out. I have one here that has already been activated if you want it. PM me with your address if you do and I will get it in the mail by weeks end. We could not use it because DD is on 27 mg.

My son is on the 27 too. The soonest I will hear anything is tomorrow.

[Urban Cowgirl]

sorry I saw "he" and assumed DH.

[Urban Cowgirl]

Elle - if it is the 18 mg or less, there are free offers in the family type mags. It is good once per year, but can get you through until you get insurance straightened out. I have one here that has already been activated if you want it. PM me with your address if you do and I will get it in the mail by weeks end. We could not use it because DD is on 27 mg.

If its not a time released drug couldn't you cut it 1& 1/2 would make 27

[iluvmybaby]

As of Feb 1st my insurance doesn't cover name brand drugs.. Concerta does not come in generic form..

My doc had to send a fax to my insurance telling them that this is the best treatment for him and there is no generic form and he needs it.

Today I go and get the script filled and my insurance kicked it back..

WTF..

Concerta is NOT cheap. I cannot afford it.. and he took his last pill this morning.. So my doc has to resubmit the paperwork to get the authorization again... and it's not a quick process.. Which is why he sent the paperwork in before the new rule came into effect.. I should have had a preauthorization already

I doubt my doc screwed up.. It's not like him . I am pretty damned sure it's my insurance.. I HATE the fact I had to go back on this one because United screwed my Primary doc and he won't accept it anymore.. It's not the first time they have screwed up major like..

I have been on the phone all day and now I have a headache ARGH!!!!

Elle, contact https://www.pparx.org/Intro.php . I dont know if you will be able to get help because you have prescription coverage. If you can't, call the company who makes it and see if they have a prescription assistance program

P S I hope that your son is able to get what he needs.

[ElleGee]

If its not a time released drug couldn't you cut it 1& 1/2 would make 27


Can't cut capsules

[xtrememom]

Concerta has a program for free medication if you are uninsured, underinsured or if you can prove your insurance no longer allows the medication on the formulary and if the Doctor says it is medically necessary. I went through it with my DS when our old insurance quit covering it and I had no issues getting it. I think I went thorugh PPARX, but I may have went to the manufacturers website directly its been over a year ago.

HTH

xtrememom

[msmom79]

call the company that makes it-they will help if you cannot get the med.have your doctor send a letter to them.most companys are pretty compassionate.

[ElleGee]

OK according to his doc we have to try the Ritalin first. If he does not respond well to it then he can send of a preauthorize request.

The new law says we have to exhaust the other options before they will cover certain drugs

I understand why he has to be switched so either way if he is on meds that work he will be fine.

Thanks for the support :)

[CLARKS4]

Elle, My parents insurance company just did that to them. They had to change my mothers blood pressure meds. Her blood pressure is like a yo-yo so very important that she gets them. Anyway they have this list of generic meds they have to go thru before he can put her back on her regular meds. This first one they have her on isnt working. They dont last long enough. By the evening she has a headache and blurred vision.
I hope that the other meds work for your son.

[ElleGee]

Ugh poor thing!! :hug

[krisharry]

Ya know, I think this is a bumch of crap, if a drug is working they should not be allowed to take you off it and make you try a bunch of other drugs which may or may not work, if it ain't broke, don't fix it. that being said I hope they find something that works and the process is quick for you both.