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Insurance changing medicine
Posted: Sun Jan 25, 2015 6:27 pm
by Arab Nights (imported)
The only medication I take is symbicort for COPD (although I think allergy is a part of that). My part D insurance company is Coventry. So I got this letter from Coventry that they were dropping symbicort from their formulary. I went to my family practitioner because I thought he could send in some kind of a petition for an exception and they would continue paying a share of it. Instead he wanted to try another drug. By the time I was on it for two weeks, I had severe acid reflux and developed really ugly chest discomfort where I just knew I was going to be in the ER or dead. I threw that one away. Then he proposed another one. The problem with it was that I really had to concentrate when standing so I did not fall over. I threw that one away, filled a statement with the FDA and went back to my family practitioner and told him that I was done with games, it was back with symbicort period. That was my decision and one way or another I was going to make that happen.
Anybody have similar experience with drug companies dropping drugs and the doc experimenting with alternatives? (I don't have a particular problem with trying because one never knows until you have tried. This is not a screed against family practitioners)
Re: Insurance changing medicine
Posted: Sun Jan 25, 2015 8:31 pm
by kristoff
Arab Nights (imported) wrote: Sun Jan 25, 2015 6:27 pm
The only medication I take is symbicort for COPD (although I think allergy is a part of that). My part D insurance company is Coventry. So I got this letter from Coventry that they were dropping symbicort from their formulary. I went to my family practitioner because I thought he could send in some kind of a petition for an exception and they would continue paying a share of it. Instead he wanted to try another drug. By the time I was on it for two weeks, I had severe acid reflux and developed really ugly chest discomfort where I just knew I was going to be in the ER or dead. I threw that one away. Then he proposed another one. The problem with it was that I really had to concentrate when standing so I did not fall over. I threw that one away, filled a statement with the FDA and went back to my family practitioner and told him that I was done with games, it was back with symbicort period. That was my decision and one way or another I was going to make that happen.
Anybody have similar experience with drug companies dropping drugs and the doc experimenting with alternatives? (I don't have a particular problem with trying because one never knows until you have tried. This is not a screed against family practitioners)
I have several times dealt with an insurance company declining a drug. I always insist that the doctor/clinic pursue a "prior authorization" for the needed drug. Basically, they have to make a case for why that particular drug is a must. Most insurance companies will then give a PA for a year at a time, hoping you die in the meantime, so that you can be discontinued. Some flat out refuse to do a PA, and then you likely have to find a different insurer.
Re: Insurance changing medicine
Posted: Fri Jan 30, 2015 1:09 am
by ZeuterMe (imported)
Never had my insurance company do it, but had plenty of experience with the doctor going fishing for other reasons. (like, the nut pain that brought me here!)
You have my sympathy.
Re: Insurance changing medicine
Posted: Mon Feb 09, 2015 4:07 pm
by baldwin92 (imported)
Just Friday 2/7 I was informed that my drug insurance no longer has my testosterone drug in it's formulary. It was listed on the website and in the booklet they sent me. But now they say nope after i tried to fill my first prescription with them. The main reason I chose this company was they show the drug much cheaper than my former drug company. I have to do a prior authorization as well but according to my pharmacy the price is going to be more than I can afford. Without testicles and subsequently testosterone I fear the things that will happen to my body and mentality. I cannot enroll in a new company until next jan.