Prescription Problems

KathrynJ088 · May 2017

Is anyone having to fight for every prenatal prescription with insurance? My prenatal vitamins weren't covered, and now Dicelgis isn't covered. Ugghhh I'm livid! And the pharmacy can't help on alternatives, and neither is my OB office, so I'm stuck researching generics that are covered that hopefully are just as good. Are my babies and my health just not important to my insurance company?!?

The vitamins were going to be $135 a month without insurance, and Dicelgis is over $800 for a 2 month supply.

GraysonsMama · May 2017

When I was on dicelgis last time I know that target pharmacy had a coupon I could use that I think made it $10 a month but my insurance ended up covering it. Maybe give them a call?

Eta This was two years ago so who the heck knows now.

NME44 · May 2017

Is there a reason you are on prescription pre-Natals? You can find great pre-natals over the counter for much less than $135/mo.

disneyfan0511 · May 2017

I've been having the same problem - very frustrating. My OB was able to get me Diclegis through Foundation Care pharmacy - it was $40 for 120 pills. I have no idea how it worked, but after we explained how we can't afford $800/month for medication she was able to make that happen. Maybe ask your OB's office if they have heard of this program? We just ordered it all over the phone and is showed up two days later. Good luck!

txmomma16 · May 2017

My doc prescribed me Prena Pearl, and it's been free each month with a discount prescription card the pharmacy found for me. Without the card it would only be $10 on my insurance. Maybe that would be an option for you?

katiegeminimoon · May 2017

Idk if you have a Meijer near you but apparently if you have a prescription for pnv they are always free. Might be worth checking out!

beary67 · May 2017

What's your prenatal? There are always discounts out there. For my diclegis, I got denied by insurance for not trying OTC meds first. The pharmacy was able to use a discount code to make 70 pills $50. Its worth it to me. Perhaps ask about that and just skip insurance.

Jellybelly119 · May 2017

Dicelgis is doxylamine (Unisom) and Pyridoxine (B6.) Both available OTC. Hope that helps!

Marley629 · May 2017

My diclegis is only approved for 20 pills every 10 days and I take 4 a day. If you go through this company "foundation cure" it ends up being a $1 a pill - I think your doctor needs to put the script through to them and they verify it and they will FedEx it to you. Is there a different prenatal that is covered?

disneyfan0511 · May 2017

@Jellybelly119 it is B6 and unisom, however Diclegis is a delayed release and it prevents peaks and valleys - it's much more effective for me (and many) than B6 and unisom, which I took last pregnancy because Diclegis wasn't approved in the US. But that is why insurance denies it - total BS if you ask me.

Jellybelly119 · May 2017

disneyfan0511 said:

@Jellybelly119 it is B6 and unisom, however Diclegis is a delayed release and it prevents peaks and valleys - it's much more effective for me (and many) than B6 and unisom, which I took last pregnancy because Diclegis wasn't approved in the US. But that is why insurance denies it - total BS if you ask me.

Pharmacist here. Thanks though.

Adding: It's worth a shot while waiting for the insurance to approve or if they won't. Trying low cost options first is a smart way to keep our healthcare costs down.

KathrynJ088 · May 2017

@nme44 I'm on prescription prenatals bc twins require additional folic acid and the otc ones don't have enough

@txmomma16 the Prena Pearl was the alternative that my insurance did cover and what I'm taking now. Silly thing is that one and the not covered VitaPearl are made by the same company

@jellybelly119 I called my OB and they approved me to take otc B6 and Unisom. They also said if it wasn't working the same, to let them know and they'd fill out the paperwork to deem it medically necessary so insurance would cover it.

Thanks for all the help and suggestions! This was definitely one of those hormone rage moments where I just couldn't deal with the complications any longer!

txmomma16 · May 2017

@kathrynj088. That's so bizarre! My doc wrote the script for vitapearl and the pharmacy helped switch it after talking to my insurance. So weird what's covered and what's not.

Jellybelly119 · May 2017

@KathrynJ088 I hate when things seem to pile on when I'm already feeling crappy and stressed! Hopefully you feel okay with the new vitamins and the OTC combo does the trick!

nothingbuttherain · May 2017

I don't know if it's an option for you, but could you possibly take a regular prenatal with an additional folic acid tablet? Plain folic acid is generally inexpensive, even though it does require a prescription. Your doctor might be able to tell you if that's a possibility.

NME44 · May 2017

Thanks for explaining why the prescription prenatals

@rebeckyjoy has a great suggestion that could save you some money!

meanwhile, my insurance hasn't yet approved my progesterone, which literally keeps the baby alive. So, I feel ya.

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