Drug Formularies

[geewiznit]

Anyone have experience with using an insurance plan that has a drug formulary? I'm considering putting my daughter into a new plan that requires special approval for any prescriptions that aren't on the official formulary list. Naturally, all three of her meds (Paxil, Abilify, Ritalin LA) are not on the formulary! The insurer won't give me any indication in advance about whether I could get these meds okayed. I'm going to call the doctor and see what her experience has been, but wondered if anyone could share their experience. Thanks!

(Eaccae! Sent you a private message on this subject!)

[tridlette]

It took a few extra days to get the pre certification for my Zyrtec, but it finally went through no problem. I found through some headaches that some of the formulary requirements with Aetna USHC is that you have to try the generic brands first, then if you need to go to the name brand, they will approve. That is the case for my Paxil.

For the most part, I found you just have to plan to refill sooner, ask the doctor for the new script a week before the current one runs out.

Good luck, let us know how it works out for you.

Laurie