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

A reader is having issues with her insurance company prescribing extra seizure medication for her child in case of an emergency. The community at Ready Nutrition reached out and gave her some solid advice.

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 originally published at Ready Nutrition™ on February 7th, 2014

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