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Post by teacherabc on Sept 24, 2012 13:16:57 GMT -5
So...after all this time, HP still doesn't have his meds. Latest reason why: the insurance company will not preauthorize the Vyanase. The doctor had prescribed Adderall but the Adderall was not available. That was one delay. The insurance company is telling the doctor they have to prescribe Ritalin and if the Ritalin doesn't work, then the doctor can prescribe Vyanase. Who gave these insurance jerks a medical license? I am so furious--if you're poor (and his insurance is for those on Medicaid, which means they know he's poor and this is all about the almighty dollar), your doctor has to treat you differently. I am so frigging frustrated right now--and so is the doctor. I have no problem with the doctor. It sounds like he fought with them. The doctor is skeptical about the Ritalin and it is clearly not what he wants to prescribe. HP has already been through several doctors and meds and it sounds like, based on what this doctor said, HP is beginning to trust him...we didn't need this...
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Post by healthy11 on Sept 24, 2012 15:53:17 GMT -5
When my son went to his doctor two weeks ago, and was given a new Adderall prescription, we were told that the pharmacy didn't have it in stock, but could get it in a couple of days. That was fine, because my son still had some left from his old Rx. My point is, what about going back to the doctor and waiting for them to fill the original Adderall prescription? (It is available in generic form. Ritalin is another med available in generic form. The insurance company probably doesn't want him to take Vyvanse, since it's NOT available in generics yet, and costs much more. My husband works for a Fortune 500 Company, but its insurance regulations sound similar to HP's policy, and if a person insists on a "brand name" of a medication once it's available in generic form, we have to pay the difference.)
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Post by teacherabc on Sept 24, 2012 17:00:33 GMT -5
I had the feeling from the drug stores (three of them) that they didn't expect the Adderall to be in any time soon).
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melb
Full Member
Posts: 23
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Post by melb on Sept 24, 2012 17:20:25 GMT -5
Insurance companies truly are a pain.
For the Adderall is it his particular dose that is still on back order where you are of the med in general. In our office we have changed the dose for scripts so kids can get the Meds for example if take 10 mg or 20 mg then you wouldnget 5 mg tabs and take more at a time. Some pharmacies will and get it from another pharmacy within so many miles.
Or if Vyanase is truly a better option than Ritalin you can write that on the request form that due to his particular makeup and past experience he can not tolerate this med (we tried this with a few patients and it's hit or miss but worth a shot if dr believes Ritalin won't work)
I'm sure you tried all the above and more but thought I'd throw it out there.
Best of luck
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Post by healthy11 on Sept 24, 2012 17:49:04 GMT -5
Our pharmacy originally told me it could take up to a week to get the Adderall dosage my son needs, but I got a call that the prescription was ready after only 2 days.
I don't know if you were trying 3 of the same types of Pharmacy (ie, CVS stores) but I find it hard to believe that if you went to Walgreens or Rite Aid or another different store, they'd all be getting their meds from the same warehouse where it was out of stock.
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Post by teacherabc on Sept 24, 2012 17:50:59 GMT -5
HP told me that the doctor called him and was going to try and do something (there is an appeal process and either HP could do it or the doctor can do it and from the looks of the letter, it seems like the doctor could do it on an expedited basis). I want to call the doctor first because there is no sense in both of us trying to possibly appeal this. As for your suggestion about the dose, I can talk to the doctor but I don't want to wind up going around in circles again with the drug store not having it...
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Post by dwolen on Sept 25, 2012 7:44:42 GMT -5
Vyvanse is in the same class as adderall, the amphetamines. A 30 day supply at Walmart pharmacies is about $173. There are prescription savings cards one can get through CHADD. It might be a good idea toget various prices from local and mail order pharmacies and prescription discount cards for emergencies, like if Medicaid is being slow about approval. Duane Reed pharmacies were bought out by Walgreens recently, so maybe the merger will make ADHD drugs more readily available (I hope.)
Ritalin is in the methylphenadate class.
Sounds like the physician is good and wiling to advocate with Medicaid on this. But I think it is going to need your ongoing attention even after the prescription is filled and the right dose is found. HP may not have the skills or attention to keep up with medication refills at this point. Perhaps after a while of medication taking, filling his ADHD medicine will become an established habit.
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Post by healthy11 on Sept 25, 2012 8:23:12 GMT -5
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Post by teacherabc on Sept 25, 2012 20:40:13 GMT -5
I will look into that. In the meantime, HP told me today that the doctor told him and said he tried to prescribe a different med (not sure what) but the insurance company rejected that as well. I will call him tomorrow.
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