Ask Tess: How can I get my insurance company to allow for extra medication?

Tess Pennington | Comments (1) | Reader Views (2697)

Tess,

My son takes seizure meds daily. With the medical scrips being only a 30 day supply how does one build up a supply of these? I have tried to figure this one out but the insurance companies make it impossible to get more than is needed for a month? any ideas?

Thanks for any info on this subject.

Gail

Answer:

Gail,

This is a very difficult question to answer mainly because the problem does not lay with the doctor approving the additional prescriptions, but with the insurance company approving them. Insurance companies will not allow more than a 30 day supply to be paid for. If the patient wants more, then they usually have to pay for it, FULL PRICE by themselves. I had to ask members of the Ready Nutrition community for help with this one. They offered some great advice, and hopefully, you will be able to use some of this advice to help your situation.

Thanks again to those that contributed all of this great advice!

“My insurance lets me refill my prescriptions at day 21 or 23 after getting the previous prescription. So if you get your prescription today 2/5 and the insurance company lets you refill on 2/28. And then next month you refill 3/23. It takes a little longer but you are basically banking a weeks worth of pills at a time and you will then have a month’s extra, then two months. We’ve done this with our daughters’ medicines.”

“Share your problem with his doctor. Some are willing to write the Rx out for twice daily as long as you understand the true directions. They’re not really supposed to, but it doesnt hurt to ask what options you have. In our office we give a sample of an equivalent name brand for those patients that regularly fall short each month. One sample is enough to cover the extra for 6 months.”

“See if https://www.alldaychemist.com/ carries the medication you need. They are an offshore site, but ships to US.”

“Ask the dr. to write the RX for twice the strength, then cut them in half.”

“Research which foods and natural oils that help your child’s condition. I had a friend who was taking meds and she is now 1 year meds free. She also talks to a nutritionist to help out as well.”

“Research cannabis oil to control the seizures.”

“Have you tried getting some from canada as well?”

“Look into treating your child nutritionally. Seizures are a symptom not an illness. Usually a lack of Vitamin D3 and omega oils and minerals and B vitamins. The child’s gut is leaky with food allergies. Try chiropractic treatments. Do you have a “smart” utility meter for your utilities? Turn off your modem and unplug portable phones near their bedroom at night. Can affect certain people’s central nervous systems.”

“If your insurance offers it, try mail order, you can usually get up to 3 months at a time. And it’s usually cheaper than buying it at the pharmacy, depending on your copays/deductibles. Also, someone already mentioned it, but save up some cash and buy a couple refills with cash. Some pharmacies have an in house discount card for paying out of pocket.”

“If you have problems getting the prescriptions, talk to a licensed herbalist. License! They may be able to refer you to some herbs that can help the condition similar but not the same as what he’s on. As there are many different types of seizure disorders, what works for one may not work for another. This advice is both from a medical and personal standpoint.”

Best of luck, and I hope you find a solution to your issue.

 

Tess

This article was published at Ready Nutrition on Feb 7, 2014

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1 thought on “Ask Tess: How can I get my insurance company to allow for extra medication?”

  1. 14 years ago my sister-in-law started having grand mal seizures at the age of 36 and came to live with us. To this day she still suffers 30-40 grand mal seizures a month. We’ve been the total gauntlet of treatment up to and including a Vegus Nerve stimulator. In some cases all the above recommendations for treatment will not work. A combination of 3 different medications do shorten her seizure state and help with a faster recovery period. Since we have been though so many medicine changes over the years we know that at some point it all becomes a guessing game.
    If our case the Doctor has prescribed certain dosages for each medication. We have also observe that over dosing always seems to kick in adverse side affects. So we know when to look for those side effects and to lower her medication accordingly. It never seems to affect her amount of seizures nor duration. IF you want to reduce the medication to see how it affects the person then do so gradually. Eventually you’ll find a place where to total medication does not have to be taken to be just as effective. Save the unused medication. Make sure you refill the medicatiion at the scheduled intervals.
    Over the years we’ve built up a good supply, enough to last 4-5 years. We rotate the medication and it’s always stored in Foodsaver bags and kept in a dark, cool place.
    The easiest way to find out of your doctor is willing to over prescribe is to voice your fears about the economy collapsing. If he/she is in agreement then it’s easy to take one step more and talk about What IF it occurs and the medication problem that will result.
    With seizure medication there is a wide variance in how it is administered and what strength. Some medication can vary from 50mg a day up to 2000mg a day.
    A big issue with people who have seizure histories that match ours is making sure the individual drinks plenty of fluids and eats normally. These drugs can often result in an individual losing their appetite and drink a lot less with results in less drug absoption by the individual as well as a lot of other issues.

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