Stupid drug plan

[rainbow_goddess]

My prescription drug insurance refused to pay for a refill of my prescription for pen needles because, according to them, I'm using too many. I went to the pharmacy a couple of days before Christmas to get a refill, and I was told "Pharmacare [public prescription drug plan, sort of like Medicare] says it's too soon for you to need a refill."

Too

Comments

[luvlyssa]

insurance plans often do that, request your doctor write you a prescription for say.... 250? 300 JUST to be safe, with an rx they can't turn you down and if they don't believe you they can call your doctor:)

[suechew]

My doctor did that for me with the strips for the glucometer, but that didn't matter. My medicare only allows one box of test strips regardless of how many times you have to test. I guess I should be lucky that they'll at least pay for the one box which is close to $40.

Drugs Not Covered

[suechew]

I just got back from the pharmacy for my monthly diabetic supplies. I had two new prescriptions for Benicar and Crestor but was told that my insurance doesn't cover these so now I have to wait until Monday to see what else my doctor could prescribe. Bummers. I hate how these insurance companies dictate whether you live or die. LOL Maybe my doc will give me the samples again as these meds work so well for me

[rainbow_goddess]

They can and they do turn me down if I want a refill sooner than they think I need one.

[missakins]

Most drug plans expect that your doc is writing a script for a 30 day supply...get him to write your script for more, so you can stock up. They don't want you re-using the needles, it's harder on your skin, and raises the chance of infection.

[rainbow_goddess]

It doesn't work that way. The doctor writes a prescription for one box of needles. I don't go to the doctor every time I need another box. I get refills on the prescription for one box. Even if the doctor wrote a prescription for ten boxes, Pharmacare would only pay for one. That's how they are. Pharmacare -- not the doctor -- decides what meds I need and how often I need them. Pharmacare has already decided that I don't need fast-acting insulin (I have to pay for it myself) and that I don't need Singulair tablets for my asthma.

my strips

[ikyschd]

I was having that problem but with strips. Originally only getting 100 per month in a Rx which was no where near enough considering I was testing 10+ a day. I got the Rx changed to 200, but it wasn't actually changed, it was just a new Rx. So then I could get the original 100, plus the new 200, and insurance always paid. Since I use a few meters now (Flash / UltraSmart) I have yet another Rx for 200 strips on the Flash. So if I really needed... I could be getting 500 strips total in one month. It's a little tricky/sneaky, but it works with no questions asked (at least for me)

Re: my strips

[rainbow_goddess]

That's great. I'm glad you found a way around the preoblem. Unfortunately it wouldn't work that way for me. I was once testing ten times a day, but I had to cut down on how often I test because Pharmacare won't pay for me to get a box of strips every ten days. "Two weeks" is what's written on the receipt, and that's how often Pharmacare will let me get a new box of strips.

[mac_finn]

Yeah, my insurance does that to me too (the only refill every two weeks thing; I guess they don't want a person stocking up or something).

Maybe you could ask the doc if he'd write a letter to the company, much akin to how some of us pumpers had to get our pumps? Having to show justification and all that. Find out who would make that decision and have the letter sent there from the doc, it might be worth a shot. :o (No pun intended...)

[aleeny_linguini]

You can re-use penlet needles... there's no harm in that, unless you're using them when they're way too dull.