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Post by eaccae on Dec 21, 2003 13:09:19 GMT -5
Health Insurance just stopped coverage on ALL adhd medications. (With insurance meds =$0 - without insurance they = $91) The doctor has to call in and go over DS's history. Since he was diagnosed by a neuropsychologist, etc. it shouldn't be a big problem - but it is time consuming. It could be over a week before it gets straightened out and approval is given! And because I can't get the prescription filled more than a week before his old one runs out - we only discovered this whole thing this week. Which means he was short his med on Friday and this weekend. I feel like pulling my hair out!!!! His teacher has implied to me in the past that she doesn't know why DS is on the meds - said in one PPT meeting that she doesn't know what behavior I am talking about because she doesn't see it at all (the principal told her of course not - he is on his meds). Well - she saw it on Friday. I wrote her a note explaining the situation and that he would need extra direction - got a note back that he had an extremely difficult day and got next to nothing done - couldn't stay in his sit, was overly silly, hummed through class . . . Guess she knows why we use medication now! I am going to call her up tonight to warn her that Monday will be the same deal. I will see his doctor Monday afternoon so she will write me a prescription for a week that I will pay for. And then hopefully this nonsense will be straightened out. I just wish the insurance company had let me know before all of this. I hate insurance companies!!! (I am still dealing with mine because they haven't paid any of my doctors bills since July even though I am completely covered - I am having some health problems - and it has started to go to collections - good old Blue Cross/Blue Shield!). I had to sign a form stating that I don't have any other health insurance - which I don't - I have now signed two!!!! When are they going to take care of this?!! Sorry for my ranting. I am frusterated and having a BAD weekedn with DS. Even DS mentioned to me that he was having a hard time. Poor guy!
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Post by AustinsMom on Dec 21, 2003 15:18:25 GMT -5
What a tough thing to have happen right at the hectic holiday season!!! It sounds like you will be able to get everything sorted out, but what an emotional and energy drain this is for you. Hang in there....and feel free to rant and rave as much as you want here. I think you'll find many kindred spirits who share your frustration with the insurance business.....Good luck.
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Post by StrugglingAgain on Dec 21, 2003 22:22:54 GMT -5
Insurance is the biggest headache in the world! We have the "mail order" kind which is just terrible when a doctor is changing meds all the time trying to find the right ones. I certainly understand where you're coming from. I also resent these insurance companies covering some of the meds and not others...no matter that your doctor has prescribed them! THEY aren't your doctors OR the patients, so what gives???  |
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Post by Honeysmom on Dec 23, 2003 8:16:09 GMT -5
Insurance companies and perscription drug companies, while using the same name, are not usually the same company. That is why they usually do not cover birth control. Why would a perscription drug company pay for something, like birth control or ADHD meds, if they know we are going to pay for them if we really have to, and the perscription drug co has nothing to loose if you get pregnant or if your kid gets hurt b/c he is impulsive.
I have had the same problems and I usually am lucky enough to get some sample packs from the doctors until my insurance get straightened out. Insurance companies are out to make $, or they wouldn't be in business.
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Post by eaccae on Dec 23, 2003 8:30:10 GMT -5
Good news - finally the health insurance mess is straightened out! The doctor couldn't believe them - she was so annoyed that "the people in charge of making decisions for my son" were complete morons. The head of prescriptions at blue cross/blue shield asked the Dr. if DS had ever tried methylphenidate and she responded yes, he's been on it for 3 years now. Well - this person told the Dr. that if it was working that she couldn't approve Metadate CD or Ritalin LA - why wasn't she continuing with methylphenidate. DS's dr. had to explain to the head of prescriptions that these WERE methyphenidate. So finally approval was given. But he is now on Ritalin LA - hopefully this works as well as the Metadate CD. I guess the person couldn't come to terms with the fact that Metadate CD was methylphenidate and that it was basically the same as Ritalin LA - so she wouldn't approve that. So here's keeping our fingers crossed.
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