Zofran insurance ?

Esbi25 · October 2013

Sorry if this has been asked before, but I was wondering what other people have had their insurance cove regarding Zofran. I finally had my first appt and the doctor wrote me a prescription for 30 pills, but the pharmacy said my insurance would only cover 10 pills every 30 days.

This seems really crazy since you are supposed to take 3 a day! So I have a 3 day supply... How dumb. Well since my nausea seems to be lessening, I am just using it as needed and will probably survive with what I have. But, I was considering calling my insurance just to ask about this. I thought I would see if this is typical for other insurance? Thanks for the info!

dragossoul84 · October 2013

That seems nuts I get 60 pills a month my insurance covers the whole thing

artichoken · October 2013

My stupid insurance only covered 12 pills! WTFF I take like 3-4 a day. ugh

LunaBug924 · October 2013

Mine only covers 13 per 30 days. Luckily Target pharmacy is awesome and gave me some kind of discount so I only paid $20 oop for the other 17. Worth every penny.

Tifers777 · October 2013

Mine only covered 6 in 30 days! I was so pissed! And so I had to wait. Sucks! Thank god my ms is going away slowly

pistolpackinmomma · October 2013

Mine will cover 28 pills per month but only 12 at a time which is stupid. Luckily I don't need all 3 every day but if I were still as sick as I was in the beginning then I would be pissed!

Esbi25 · October 2013

Wow, I guess mine isn't too far from the norm, though 10 seems to be the lowest number! That is so lame considering MS can last for weeks (or months for some)! Maybe I will just call them to express my opinion, might make me feel better haha

katesy21 · October 2013

That's crazy! I paid $6 for 30. I only take it in the morning so it should last me but I will probably fill my refills too. Zofran is a good thing to have handy!

CamrynnsMommy · October 2013

I get a generic form covered by insurance.

dragossoul84 · October 2013

Is there any place to donate extra meds, I know that some people can't afford them and I think I will end up with more Zofran than I need or is this one of those medications you cant mail/donate?

krlovell · October 2013

dragossoul84 member
12:41PM
Is there any place to donate extra meds, I know that some people can't afford them and I think I will end up with more Zofran than I need or is this one of those medications you cant mail/donate?

This!!!! DH and I totally had this conversation yesterday!! I have my zofran, phenegran and lortab (for migraines) that I'm not taking. I don't want all kinds of meds in the house because of DS even though our house is child proofed it just stresses me out the kid can get into anything. And I feel so wasteful just flushing them!

MissLadyTay · October 2013

My insurance covers whatever I need. I didn't know insurance could dictate amount of medication. I would see if your doctor can advocate for you.

JennyOR30 · October 2013

krlovell said:

dragossoul84 member 12:41PM Is there any place to donate extra meds, I know that some people can't afford them and I think I will end up with more Zofran than I need or is this one of those medications you cant mail/donate?

This!!!! DH and I totally had this conversation yesterday!! I have my zofran, phenegran and lortab (for migraines) that I'm not taking. I don't want all kinds of meds in the house because of DS even though our house is child proofed it just stresses me out the kid can get into anything. And I feel so wasteful just flushing them!

Check with your community and see if they have a free clinic. Most of the time, free clinics will take. Used to work in a chemotherapy clinic and when patients passed away their families would try to bring us their leftover meds and we couldnt take them, so we'd refer them to free clinics

JennyOR30 · October 2013

MissLadyTay said:

My insurance covers whatever I need. I didn't know insurance could dictate amount of medication. I would see if your doctor can advocate for you.

Not only can insurance dictate how much of a med you can get, but they can also dictate whether or not they want you to try something else first. I use to work in a chemotherapy clinic and we had to do PAs all the time bc they wanted chemo patients to try Zofran before we put them on a drug called Emend (which is wonderful for cancer patients on strong chemo). The insurance companies would try to say they were the same thing (not even in the same ballpark) and usually we couldn't give zofran bc it interfered with anti-nausea meds we gave in clinic.

ns1 · October 2013

Yep..only 11 in 30 days here too. I'm thinking of just paying oop. I feel like crap and need to be at work! For 11 generics it looks like it will be about $20, which sucks but could be worse.

Soccer407 · October 2013

Call your insurance and you can appeal it.

artichoken · October 2013

dragossoul84 said:
Is there any place to donate extra meds, I know that some people can't afford them and I think I will end up with more Zofran than I need or is this one of those medications you cant mail/donate?

wantmy address??? Lol

Soccer407 · October 2013

You can defiantly pay oop for Zofran which is typically very expensive. Call your insurance first and try and appeal it. It's worth the shot.

chillypenguin · October 2013

I got the generic Zofran, 30 pills for around $23. Have you tried getting generic? Luckily my insurance hasn't limited mine.

Esbi25 · October 2013

ns1 said:
Yep..only 11 in 30 days here too. I'm thinking of just paying oop. I feel like crap and need to be at work! For 11 generics it looks like it will be about $20, which sucks but could be worse.

$20 isn't bad. I am not exactly sure of the cost. But, I had to call the pharmacy to update with my new insurance info and the guy said oh yeah, you definitely want to bring your new card because right now it is like $190... And that was for the 30 pill prescription.

Over $6 a pill is just not even worth it to me! I think my nausea is easing up now at 9 weeks, so I'm hoping to make due. I may try to call and appeal though just to see what happens and to have a little 'just in case' supply.

Esbi25 · October 2013

chillypenguin said:
I got the generic Zofran, 30 pills for around $23. Have you tried getting generic? Luckily my insurance hasn't limited mine.

I believe it is generic that I have, actually. Still expensive for some reason... Maybe I need a new pharmacy? Haha

ns1 · October 2013

Esbi25 said:

ns1 said:
Yep..only 11 in 30 days here too. I'm thinking of just paying oop. I feel like crap and need to be at work! For 11 generics it looks like it will be about $20, which sucks but could be worse.
$20 isn't bad. I am not exactly sure of the cost. But, I had to call the pharmacy to update with my new insurance info and the guy said oh yeah, you definitely want to bring your new card because right now it is like $190... And that was for the 30 pill prescription.

Over $6 a pill is just not even worth it to me! I think my nausea is easing up now at 9 weeks, so I'm hoping to make due. I may try to call and appeal though just to see what happens and to have a little 'just in case' supply.

Well, there's some perspective. $20 seems awfully reasonable now!

sweetky_06 · October 2013

Zofran is limited, just like many other meds like Imitrex (for you migraine sufferers) are also limited on what insurance will pay for within a certain period of time.

Typically, your Dr. can submit an appeal and insurance will accept it. Zofran for morning sickness is "off label" use. It is officially for nausea caused by cancer treatments, and leukemia treatments are usually is short bursts (a few days) which explains why they seem to only dole out enough for a couple of days worth.

But anyways - ask your Dr. to appeal to your insurance company. Drs prescribe what they think is best and they have no way of knowing what your specific plan does or does not cover unless you inform them.

KayeH2014 · October 2013

My insurance covered 30 pills for 30 days. Right now, I've been trying to only take 1 a day, sometimes it's more than 1. I think I paid about 23.00 for the month supply.

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