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Thread: Help! Insurance forced switch to generics!

  1. #1
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    Default Help! Insurance forced switch to generics!

    Hello...I haven't been on in awhile, and you've probably covered this topic. Excuse me if you have. I take 6 medications (5 are name brand). My COBRA has just ended and I have to go on my husband's insurance. They do not cover any of the name brands. My doctor said if we could switch to generic but make sure it was the same generic each month (for the 5 meds)...we could probably manage it. I've gone to only 2 pharmacies so far, but they both said they "never know which one they're going to get. It depends on which is cheapest that month and other factors." Has anyone had this problem? Is there a way to get the same generic each month? Is there a private ins policy that will cover expensive brand name meds? I've heard horror stories about switching to generics when it comes to neurological meds. I had seizures from the time I was 11 years old until a Temporal Lobectomy in 2001. Panic attacks started right after surgery, but they've been under control (for the most part) using seizure meds as many conditions do. The meds I take are Neurontin, Tegretol XR, Lamictal, Zoloft, Seroquel and then generic Ativan. Thank you for any information!

  2. #2
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    I do not have a good answer

    But, I had the same problem with my wife’s med.

    CVS/Caremark wanted to bill me for the non-generic “name” brand. $$$$$$$

    My wife’s epileptologist wrote an appeal and the three month supply of Lamictal is now more manageable, about 15% of the original non-generic amount.

  3. #3
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    ((((((SAK89)))))) ~

    Welcome Back!

    I don't have an answer either, and I'm sorry that you're faced with this situation.

    My suggestion: Send a Private Message to Pharmacist Steve, who is our resident Pharmacist here at BT. And try contacting him through his website: www.pharmaciststeve.com

    I truly hope that you're able to get your meds sorted out so that they are safe for you.

    Love & Light,

    Rose
    Mom to Jon, 48, (seizure disorder; Gtube; trache; colostomy; osteoporosis; hypothyroid; enlarged prostate; lymphedema, assorted mysteries) and Michael, 32, (intractable seizures; Gtube), who were born with an undiagnosed progressive neuromuscular disease and courageous spirits. Our Angel Michael received his wings in 2003 and now resides in Heaven. Our Angel Jon lives at home with me and Jim, the world's most wonderful dad.

  4. #4
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    Hi SAK89,

    It's great to hear from you again I just wish it was under better circumstances. My advice to you is to speak to your state insurance agency and also let your Dr. know what's going on.
    If you tell your state ins. agency they can go after your ins. co. and correct things so they are safe for you. I had the same surgery as you did and I have found that taking vitamin B12 once
    a day has greatly reduced my sz. Try taking that and also you may be taking to many sz. meds ask your Dr. to do a DNA test on you this will show what sz. med will work the best for you with
    the least side effects.
    Here's wishing you only the best and May God Bless You!

    Sue

  5. #5
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    Here are legitimate sources online sources outside the US. Here are the steps to take.

    1. First,Look into http://www.rxrights.org
    2. Second, when comfortable with the process, go to http://www.pharmacychecker.com to order .
    3.Type the name of your medication. If brand-name, specify that. A list comes up with the stores which sell your med, at what price.
    4. Call the chosen pharmacy. They will ask for a prescription from your doctor.
    5. Fax your prescription to the pharmacy .
    If this is your first time setting up the account, it may take 3 or more weeks. Your med will come from the specific manufacturer, but the plant may NOT be in this country. That's o.k, because many if not most drug companies have plants all over the world AND the formulation (Make sure BOTH active ingredient and inert ingredients IS the same as the brand name.)

    LinnieC

  6. #6

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    I dealt with this on behalf of my husband this year and it about made me crazy. Our insurance plan renewed on June 1, and when I went to pick up the prescription monthly renewal was floored when they said it would cost $900. Fight fight fight, call, call, argue argue.... we finally got it sorted. THEN I went to pick up the second renewal (different med) and that one was over $1000. Fight fight fight, call, call, argue argue... no success. Also no explanation that I was happy with. The insurance would make the brand name medication available, but would not give me the insured price. So we paid that price for two months. Month three went in, braced myself for the cost, and *bing* the price was waaaay down to like $86. I called, and they said they had 'renegotiated the price with the pharmacy". Excuse me while I say $%%#? At this point he has reached his out of pocket maximum, and everything till the end of the year is "free".

    Sorry, I just kind of had to tell someone that story. The whole process was excruciating and confusing.

    The upshot of this is that my husband did after all start on a generic extended release version of Keppra. And he has had NO problems at all. His neuro said that he is much more comfortable now with the generics. That is meant to be a word of optimism to counterbalance the horror stories.

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