damn acid relflux

schmidters10

I had an incident about a month back where I ended up in the hospital with dehydration and needing 4 bags of fluids. We thought it was just the flu but when I consistantly couldn't keep things done and some further testing was done. I was diagnosed with severe acid reflux.

The ER doctors prescribed me Pepcid. It was a life saver. I was finally able to eat again and it actually helped alot with what I thought was morning sickness. Not the case actually a lot of it was the acid reflux for about 2 months.

So I went back to my doc last week and we talked about my visit to the hospital and I asked if he could give me another script for the Pepcid because the one I got from the ER had no refills and I was down to only a couple pills.

He agreed to give me a prescription but stated that it would have to be for Proxitin instead of Pepcid because my insurance wouldn't cover the Pepcid. I agreed not thinking that my insurance had covered it completely when I got it from the ER.

Here is my problem. The Proxitin does not work. I am back to my nightly throwing up around 2 in the am. No matter what I eat when I lay down after a few hours I am up from the intense burning in my throat and 9 times out of 10 it results in my throwing up. The Pepcid took it away like a miracle pill...I want it back lol

My question is does insurances cover different meds when the script is from an ER doctor then from your normal doctor. Because this is the only thing that I can think of that would change that the Pepcid was covered when the ER doc prescribed it and that my doc said it won't be covered  if he prescribed it.

Any help is appreciated in advance. I am up suffering now at 320

blondejeni

Acid reflux sucks ... The big one.  And I can totally relate to your woes, sorry to say -- but not all bad news!  There are some things you can do to help with it -- like changing your diet a little?  Try avoiding high fat and overly spicy foods. Also citruses and sugary sodas can come right back up...quite literally.  And green leafy veggies also can be a trigger.  Chamomile tea can be settling (and mint also)-And always make sure you're drinking plenty of water. I have found starchy vegetables and plain crackers can also be helpful-- not like a double helping of mashed potatoes is at the top of my cravings list, but it can work.  Hope you feel better! 

 

Oh -- and give your insurance company a call to see what's going on with the Pepcid.

rakle99

Talk to your doctor again. He may be able to call the insurance and get them to cover it. you can also appeal it yourself, but your doctor should have more luck.

anao2020

rakle99:

Talk to your doctor again. He may be able to call the insurance and get them to cover it. you can also appeal it yourself, but your doctor should have more luck.

 

This. I would talk to the doctor and see if he'll call your insurance company and verify what they're willing to cover for Pepcid. If it was covered for the ER prescription, it should be covered from his. Was the ER in the same hospital? Also, I would check if the main prescribed action for this pill is acid reduction/supression. That could be part of the issue.

I would just call and verify with everybody. After giving the doc a chance to talk to them, I would also call and ask if there's anything else the insurance can recommend for the situation.

AKH307

Pepcid (famotidine) is over the counter...just go buy some!!

AKH307

Also, what is Proxitin?   I am a pharmacist and have never heard of it!

dukemeli

This has been an ongoing fight for me. I have had acid reflux for many years. Because I am pregnant, the pool of meds that are class B is quite small. It was further reduced because my insurance company refused to pay for several. I am now on Lansprozole 30mg. While it is not my drug of choice, it is certainly better than being on nothing at all. Acid reflux is miserable. I hope that you get some relief soon!!

dukemeli

I think that Proxitin may be Protonix.

schmidters10

AKH307:

Also, what is Proxitin?   I am a pharmacist and have never heard of it!

 

I am sorry I was doing it wrong. It is Protonix. Is Pepcid over the counter the same strength as the one you get prescribed?

dukemeli

The one that I was prescribed is stronger than Pepcid. Pepcid unfortunately does nothing for me.  My PPI of choice is Dexilant but insurance won't pay for it anymore.  I get complete relief with it. I have also been on GERD meds for almost 15 years. Lansoprazole gives me enough relief where I am not completely uncomfortable.  For that alone, I am completely grateful.

Kadyra

You can ask for Pepcid and have it filled at Walmart, target, or a Kroger chain for only $4. That's where we get our Claritin and Pepcid. 

kabbride06

I was in the same situation as you with my first pregnancy. Its horrible! I was prescribed Prevacid and it was only partially covered. My doc tried her best to get my insurance to cover it fully but they denied it. So, i paid out of pocket. It was the only meds that worked. I figured it was worth every penny cause i didn't want to be back in the ER. If you can afford it, just pay it. It's worth it! Good luck and hope you feel better soon!

schmidters10

I have a call into my doctor now. Waiting for a call back. I am hoping that he can get it changed back to pepcid. I checked and the mgs that I was taking are not offered over the counter. So I figured I would just pay for the prescrition, because it worked wonders