So, my insurance refused to cover a Diclegis prescription and I'm supremely annoyed. Did anyone else have this issue? We haven't had a problem with Anthem thus far since switching to them a year and a half ago. Not sure why they're being such asshats about this considering you can cobble together an OTC equivalent for like $20.
My doctor checked my insurance and said diclegis wasn't going to be covered so I never tried. She is a saint though and gave me a sample bottle with a 100 diclegis pills in it. She says they save the samples for the people who have insurance that won't cover it.
It was going to be $450 OOP for 60 pills. I mean, WTF. Apparently you can do 25 mg of B-6 3-4x a day plus half a tablet of plain unisom at bedtime and it is the same thing.
@chrlyr I had the same thing happen, but my OB did a prior authorization and got it covered. I tried the OTC, but it did not work as well. I think Diclegis is delayed release so maybe that is why it didn't work the same for me. I hope you can get it worked out or that the OTC version does the trick!
Call a couple other pharmacist in your area and compare out of pocket costs.. can be hugely different. Also call your insurance company and ask if you get a authorization if they will cover it
If your a Costco member try there as well for out of pocket costs. I'm on an allergy med (when not preggo) that is $60 with insurance at a typical pharmacy and is $28 out of pocket at Costco.
The doctor's office called for preauthorization and they still denied it. I got a letter in the mail from Anthem saying that I had to try both the components of Diclegis (B-6 and Unisom, essentially) separately before they would approve it. Not to jinx myself, but m/s has been kind of tapering off, so I might be okay without it.
My insurance wouldn't cover the combo pills if the parts were available separately. Since Diclegis is basically unisom and B6, they may not want to pay for the combined drug. My dr gave me a coupon from the manufacturer that brought the cost down to $30. Maybe your doctor could get that for you?
Your health and welfare are of the utmost importance to all of us at The Bump. We want you to be aware that there are rules and regulations regarding the sale, acceptance or donation of medications, including fertility drugs, and in many cases may be illegal. Such offers, sales, exchanges or other transactions are expressly prohibited on or through The Bump. We do not allow or endorse any of such offers or transactions and expressly disclaim any responsibility with respect thereto.
Re: Diclegis and Insurance
EP: 2.17.2016
DS: 3.4.2017
DD: due 7.16.2019
Me: 37, DH: 36
Started TTC #1: 9/2015
Preliminary labs/testing @ 6 months: TSH, A1c, progesterone, prolactin, SA, HSG all normal
BFP: 5/19/2016, M/C: 5/29/2016
BFP: 6/22/2016 EDD 3//6/2017
Me: 37, DH: 36
Started TTC #1: 9/2015
Preliminary labs/testing @ 6 months: TSH, A1c, progesterone, prolactin, SA, HSG all normal
BFP: 5/19/2016, M/C: 5/29/2016
BFP: 6/22/2016 EDD 3//6/2017
Your health and welfare are of the utmost importance to all of us at The Bump. We want you to be aware that there are rules and regulations regarding the sale, acceptance or donation of medications, including fertility drugs, and in many cases may be illegal. Such offers, sales, exchanges or other transactions are expressly prohibited on or through The Bump. We do not allow or endorse any of such offers or transactions and expressly disclaim any responsibility with respect thereto.