Irritable Bowel Syndrome and Digestive Health Support Forum banner
1 - 5 of 5 Posts
G

·
Discussion Starter · #1 ·
I started a new job 6 weeks ago and just had to go and get my Lotronex refilled and my new coverage (BCBS) wont pay for it. The bastards!!! Medica, which I used to have, did pay for all except my copay which was 9.00 and now the pharmacy wants 147.00 for 1 months worth of pills. Are they out of their minds?Anyone else experiencing this?------------------Robin
 
G

·
Discussion Starter · #2 ·
I so know what you mean!! I just started Lotronex Yesterday and I had to borrow the money off my Dad and Mother-in Law for ahlf of the perscrition until I can afford the rest! I have Select Blue, they are supposed to be the best. they suck!! Someone gave me this number to an advocate that will help you get the medicine. I haven't had a chance to call yet but here is the number.1-800-722-9294, tell them that your dr proscribed it and you health insurance won't pay for it. If it is working for you, you should be able to have it so try giving them a call. Let me know how it works out for you. Good luck!!Kendra
 
G

·
Discussion Starter · #3 ·
insurance companies can be real ****** well, you know what I mean!it is a good idea to work with the office staff of your doctors office. they can request a "prior authorization" from the insurance company. they fill out a form, and fax it to the insurance company. On the form it is VERY important for them to say that the patient (you) has failed on other treatments such as antispasmodics, antichlorgenics, and antidiareals (Imodium).the insurance company is required (by law) to answer the request, and give alternative treatment options (ha!) It is sometimes hard to get your doctors staff to go through this trouble to get the script covered, but if they are nice they will try! it may take a couple of days, and you will probley have to pay a co-pay ($5 - $50 per month) but it beats the heck out of $147!!! also, ask for lots of samples while you are waiting to get your script covered (why not, it dosen't hurt to ask!)good luck, and may the insurance company executive who deny coverage have a real bout of "D" on their next night out on the town
 

·
Registered
Joined
·
179 Posts
Hey! I don't know about your insurance...I'd protest it somehow. Is it because its a new drug? I got my first presc. of lotronex today and the payment was 15 bucks.------------------19 year old female, college student,*D* type Email me Katz16000###yahoo.com
 

·
Registered
Joined
·
880 Posts
We had similar problems when my mother-in-law needed Aricept for Alzheimer's and Aricept was new (and also about $150 a month). Start by talking with your doctor. We had to have the doctor write to the insurance company, just like Renee described above. The doctor was able to give us enough free samples to get us through a couple of months. In the meantime, contact your state attorney general's office and find out the procedures for filing a complain with the state. You'd be amazed at how much of a reaction you can get when you write a letter to an insurance company with "CC: (insurance complain people or AG's office)" on the bottom. Then they know you know what you're doing. Good luck!
 
1 - 5 of 5 Posts
This is an older thread, you may not receive a response, and could be reviving an old thread. Please consider creating a new thread.
Top