Psycho-Babble Medication Thread 699658

Shown: posts 1 to 7 of 7. This is the beginning of the thread.

 

Step Program after a year and a half

Posted by Glydin on November 1, 2006, at 17:55:45

My insurance company is "requiring" me to switch meds to prove I "need" the brand name med I'm currently taking as opposed to it's sister med that is SURPRISE - generic. This is after a year and half of successful use and them covering it for that period of time. Suddenly, it's off their formulary and a step protocol is required for a nonformulary med.

I feel quite angry.

 

Re: Step Program after a year and a half » Glydin

Posted by river1924 on November 1, 2006, at 19:59:08

In reply to Step Program after a year and a half, posted by Glydin on November 1, 2006, at 17:55:45

Section D of the Wall Street Journal for October 32st has an article titled "Employess, Insurers Push Generics Harder."

It says "employess...will encounter more-aggressive efforts to make generics the clear cut choice."

You aren't alone apparently. Some reimbursement programs allow docors to write letters of exception and with psych drugs, stopping them and restarting them sometimes makes them ineffective. Check into it.

R.

 

Re: Step Program after a year and a half

Posted by Phillipa on November 1, 2006, at 20:07:53

In reply to Re: Step Program after a year and a half » Glydin, posted by river1924 on November 1, 2006, at 19:59:08

Medicaire is doing the same thing with all meds in part D. Love Phillipa. If push comes to shovel pay for it out of pocket. I do this all the time. And I'm angry too. We all should be

 

Re: Step Program after a year and a half

Posted by Glydin on November 1, 2006, at 20:36:37

In reply to Re: Step Program after a year and a half » Glydin, posted by river1924 on November 1, 2006, at 19:59:08

This wasn't a new experience. I've gone thru it with my Father's statin RX and his Medicare Part D. Fortunately (???) he had failed to achieve adequate labs prior, so while it was pesty paperwork, we worked that out. I really did not think it would happen to me in light of the previous. I am stunned.

I haven't taken this up with the doc. I received this info with ordering my refill. Next is exploring what I can do to not rock a good boat.... Geeshz, it's always somethin'....

 

Re: Step Program after a year and a half » Glydin

Posted by Phillipa on November 1, 2006, at 21:14:28

In reply to Re: Step Program after a year and a half, posted by Glydin on November 1, 2006, at 20:36:37

Well that med is important to you I know you will find an answer. Love Phillipa

 

Re: Step Program after a year and a half » Glydin

Posted by valene on November 2, 2006, at 8:40:39

In reply to Step Program after a year and a half, posted by Glydin on November 1, 2006, at 17:55:45

> My insurance company is "requiring" me to switch meds to prove I "need" the brand name med I'm currently taking as opposed to it's sister med that is SURPRISE - generic. This is after a year and half of successful use and them covering it for that period of time. Suddenly, it's off their formulary and a step protocol is required for a nonformulary med.
>
> I feel quite angry.

Glydin, I understand your anger. My insurance co., Blue Cross/Blue Shield, turned down my doctor's script for the name brand "Xanax" because generic has been out forever.

My doctor went to bat for me and wrote in what Blue Cross calls a "prior authorization" (medical necessity). My doc. faxed in the form and she assured me she has had very good luck with BC/BS.
They then approved the name brand. So don't lose all hope - get your doctor involved. BTW, I received a letter from BC/BS that I am covered for name brand until the year "9999"
Best,
Val

 

Re: Step Program after a year and a half » valene

Posted by Phillipa on November 2, 2006, at 18:20:01

In reply to Re: Step Program after a year and a half » Glydin, posted by valene on November 2, 2006, at 8:40:39

Valene that's great you did it. So now that you know you'll have it are you less anxious? Love Phillipa as I think stress makes it much worse


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