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frustrated with insurance

sourpopsourpop
in Multiples

Sorry my post are all about morning sickness these days, but its still my biggest challenge so far.  My insurance will only let me get 12 Zofran pills at a time with a co-pay of $10.  I go through 12 pills in 2.5 days - which is really going to start adding up here QUICK.  I called my nurse and she is going to try and get something worked out.  She said I could also try Dramamine. 

I am just very frustrated. It's so hard feeling sick all the time and paying for pills that only really "take the edge off".  I really just want to feel better. :-(

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Re: frustrated with insurance

  • KatieLWKatieLW
    Did your doctor say it was ok to use generic? My insurance will only cover 12 pills at a time as well, but it only costs me $1.00 instead of 10 because they got me generic instead of name brand. I've been trying to only take them when it's really bad, otherwise it really doesn't seem to make much of a difference.... I feel your pain!
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  • kimarino13kimarino13 member

    That sucks!  Are you getting the generic version?  If not, will they possibly cover more because it's generic?

    I got 30 at a time (for $10) of the generic and was able to refill every 2 weeks. 


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  • sourpopsourpop
    They actually are generic. :-( 
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  • kimarino13kimarino13 member
    Well dammit!  What's the other stuff that's prescribed?  Reglan?  Would you have better coverage with that?

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  • sourpopsourpop

    imagekimarino13:
    Well dammit!  What's the other stuff that's prescribed?  Reglan?  Would you have better coverage with that?

     

    She is prescribing me that stuff that starts with a P that causes fatigue for night time along with more Zofran. I am really tempted to just suck it up during the day and take pills at night so I can sleep.  Nights are typically the worst time for me anyways.

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  • KatieLWKatieLW
    I've tried Phenergen too - is that the P one you mentioned? I've taken it at night and it has helped some with sleeping....
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  • Hibiscus2007Hibiscus2007
    My insurance is the same way.  12 pills at a time for $15 copay and they are generic already.  I have been able to get away with just 2 pills a day instead of every 6-8 hours.  And the past week I have been down to one pill a day and suffering through the rest...It does add up quickly.
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  • preheatedovenpreheatedoven member

    :( That just sucks. I wish I had leftovers I could send to you.

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  • sunnybrook.sunnybrook. member

    Walmart has the generic Reglan (Metoclopramide) on their discount pharmacy list. Its $4 for 60 pills or $9 for 180.

    I would first call Walmart and see if the meds you have been prescribed are also part of their discount program. If not, I would ask the doctor to prescribe the generic Reglan. Hope you find a solution soon. HTH!

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  • mommyof4boysmommyof4boys member
    There should be a person at your OB's office that can help to make the insurance allow more.  My insurance was like that however my SIL, who was the OB on call nurse was the one that got them to approve for more.  I ended up having a casemanager for my insurance who also helped to expite things; she was even the one to suggest a contraction monitor with my youngest son.
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  • MomOfTripsMomOfTrips

    I had a lot of problems from my insurance about the Zofran. It is because Zofran is more expensive then Phenergan (out longer and has a generic), but Phenergan is not recomeneded at all for pregnant women and has had issues over the years.

    Basically my docotr's office had to talk directly with my insurance company  and explain why I needed the dose and amount of Zofran. Basically justifying it to the insurance company. Then they had to do this process again when I had been on it for six months. It is a pain but worth it. If it wasn't for the Zofran I wouldn't have been able to keep anything down at all. The nausea was really bad.

    I would suggest calling your insurance carrier, explain you are carrying multiples, and explain the situation. Ask them what you or your doctor's office needs to do in order to get the correct amount of pills that are prescribed. Sadly it is just about money to them.

    I hope this helps a little.

     

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