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being told drug not in plan anymore, grrrrrrrr

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  • being told drug not in plan anymore, grrrrrrrr

    I am being told certian meds I need to switch and stop taking because my insurance made a change. Doesn't affect the IC since Elmiron is the only drug for it. But does affect my GERD, Allergies, Epilepsy, and I am just waiting to find out what else (pain, heart, who knows) I have tried drugs to find out what helps me the most. I do and they tell me they won't pay for it anymore. GRRRRRRRRR cussing Anybody else dealing with these problems. I mean we depend on the insurance. When it controls thing that can mean more problems to me, it makes me so angry. cussing Telling me I can't take the one drug that has helped my GERD feal better. That affects all of my health because it affects how willing I am to eat at all. Changing my Epilepsy meds will mean I will probably seizure during the change.
    Faith, Hope, and Love,

    I believe God is using me. He uses me for God. Things I gain from all my suffering are meant to help others. I hope I can help you too. Email me or start a chat if you like my help or anything. I CARE!Illnesses: IC,IBS, IBD, GERD, PFD, Epilepsy, Endo, Allergies, RLM,Rapid heart beat, low blood pressure,Gastritis,Gall stones,Tendonitis,migraines, Shingles, Prolapsed pouch,ext. fatigue (current problem) I have seen periods of remission and I have seen them end and return. At this time remission is over and working on getting it back!

    IC Volunteers are not medical authorities nor do we offer medical advice. In all cases, we strongly encourage you to discuss your medical treatment with your personal medical care provider. Only they can, and should, give medical recommendations to you.
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  • #2
    Based on your medical history this may be a case where if your Dr. steps in and talks and writes a letter to insurance they may still cover it.

    Insurance is a real pain, ours is changing again too in Jan. We did get lucky and all our Dr.s are on the new one and in fact we are going to get one back that we had lost. But there are increases and they are adding another tier in the drug formulary that I am sure will affect some people.

    I would definately talk to your Dr. and see what he can do for you in this case. Good Luck.


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    "IC Angel Volunteers are not medical authorities nor do we offer medical advice. In all cases, we strongly encourage you to discuss your medical treatment with your personal medical care provider. Only they can, and should, give medical recommendations to you."


    • #3
      You're not alone Katrina. A lot of insurances wont cover some formulary or nonformulary drugs. Most times they even make you try something else over and over before they'll take that next step and finally pay for it. I know it's such a pain in the rear end..
      At least mention this to your doctors. Maybe they can get you on some kind of assistance?
      Tons of support,

      IC angel helping families in need for the holidays. [email protected]


      • #4
        Dear Katrina,

        Like others here, I've struggled with my insurance company many times with meds and doctors visits. But I am thankful to have insurance, b/c things would be even worse without it.

        Usually, you can't qualify for assistance from drug companies with meds if you have insurance or some type of prescription coverage.But it is always worth a try to investigate it.

        I have had many medicines covered that were not on my insurance formulary with a Prior Approval form filled out by the doctor and letters from doctors. That is one option.

        Getting some samples from the doctor is also a good idea. It might not be a long-term solution, but can help lower the costs. Of course this only works for brand-name drugs b/c docs don't have samples of generics.

        Hopefully, you can find something that works for you!

        Nicole blink


        • #5

          I agree talk to your Doctor, they can sometimes wrtie letters to your ins. company to et these meds for you.

          My insurance co. just doubled my co-pay on DitrpanXL, so I understand how frustrating they can be.


          • #6
            I know exactly what you are going through. I am on medicaid but here it only covers 3 prescriptions a month. Well, I am on 13! 3 Bladder meds, 2 GERD meds, an anti-depressant, a stool softener, which doesn't help much for my IBS, 2 hormones, a migraine pill, a cholesterol pill and a pill to keep the fluid down in my brain. Plus the over the counter allergy pills I have to take every night just so I can breath.

            My pharmacist WAS getting an extention every month to cover the others but for some reason all of a sudden I am now expected to pay for all of them. I just can't do it. It's actually impossible.

            I will say he has been a God send though because he has been letting me charge while my husband was out of work. Sad thing is, now we owe him hundreds and it is going to take a lifetime to pay back while trying to continue to pay for my meds at the same time. frown


            • #7
              This is what my doctors done they called the inc. and told them I had to have these drugs. IT WORKED. I now get my drugs and some even to know cost to me. Please talk to your doctor about calling your inc. this may very well help. Sending you Tons Of Luck.
              Medicine taken daily or as needed:
              1. Heaprin and Marcaine rescue installment 1 to 3x daily as needed.
              2. MS.Cotin 100mg 3x daily
              3. MSIR 30mg 1 or 2 every 4-6hrs as needed for breakthrew pain.
              4. Fentanyl 100 mg Change every 48hrs.
              5. Gentamicin 80mg install after each rescue treatment
              5 Leviquin 500mg self start as needed.
              6. Klonopin 1 or 2 daily as needed.
              7. Prosed/DS as 1 every 6hrs as needed.

              I have IC, but IC doesn't have me anymore!