Stupid pill limits!

RisuNeko · Apr 10, 2015 at 03:04 PM

I have been wrestling with pill limits imposed by my insurance company for months now and its getting really frustrating. My crappy pharmacy isnt helping. Im switching pharmacies as of today to the pharmacy at my pdoc and therapists office because they can more easily and more willfully get ahold of my pdoc to get a prior authorization to override the pill limit.

I dont see how 15 ambien per month is admissable. What am i supposed to do? Sleep half the month? Thats what ive been doing for the past 3 months and probably part of why i went manic.

And only 2mg klonopin a day? Im supposed to take 2.5 so i run out early or dont take it as prescribed. Its ridicuous.

Does anyone else have as lame of insurance as i do?

sideblinded · Apr 10, 2015 at 03:14 PM

Riso....I have quantity limits on my pills as well. My NP is smart to this problem.

She prescribes a larger dosage and tells me to cut the pill in half so it last the whole month. Ask your prescriber to do this. If they won't, I would change doctors. Most insurances have quantity limits on certain medications. It is about supply and costs. Best wishes.

RisuNeko · Apr 10, 2015 at 03:16 PM

I already did this. I switched to 2mg clonopin instead of 1mg. They put the limit on the mg not the quantity. Maybe thats only for controlled substances im not sure. But thanks for the advice anyway.

sideblinded · Apr 10, 2015 at 03:41 PM

Quote:

Originally Posted by RisuNeko

I already did this. I switched to 2mg clonopin instead of 1mg. They put the limit on the mg not the quantity. Maybe thats only for controlled substances im not sure. But thanks for the advice anyway.

I have never heard of dosage limits.....the doctors are the ones to decide this....I am not familiar with this at all... This is when you need your doctor to help override these insurance companies. Sorry I couldn't help.

Apr 10, 2015 at 04:33 PM

I used to run into similar problems. Sometimes the pharmacy (Target) would use a prescription discount card (there are several available) to get around the pill limits. For generic drugs, the cost with the prescription discount card was often less than my insurance co-pay.

raspberrytorte · Apr 10, 2015 at 07:52 PM

I've never heard of this before! That's sucky.

Perna · Apr 11, 2015 at 12:37 AM

I had a problem with my doctor writing the prescription different time before last so I got less and it took an embarrassing argument with my pharmacist (whom I have used the last 5-10 years, know and trust) for that to come out. I would discuss the problem with your doctor and see if they can write things so it's not so obnoxious.

RisuNeko · Apr 11, 2015 at 02:30 PM

I think my pdoc is trying now to get a prior aithorization from the insurance company tocover the full amount. I mean its one measly mg more than they want to give out. I dont see how that could be a problem. You never kno though. I had never heard of dosage limits either. Just another way our insurance companies want to downplay oir well being.

I cant use my prescription discount card because they said the insirance would say it is double billing even if im paying for the remaining pills myself. Explain that to me in plain terms because i dont get it.

berthegel · Apr 11, 2015 at 03:51 PM

Hello ,
how much do you guys pay for meds and how ?

In the UK everyone pays national insurance out of their pay
This entitles them to NHS prescriptions which are £8.00 each time , if your unemployed or on certain benefits you can get them free.
I have recently been on pregabalin ( which costs £70 to make one prescriptions worth )
It was costing the government £200 million alone on pre gabalin
Then gabbapentin came along which was much cheaper to make
Are there not more cost effective meds your insurance company would let you have ?
Or could you say get all the people on say ambient or klonpin to get a group insurance so you could buy meds in bulk ?
Or am I being niave ?

Also in UK if you have under active thyroid you can get free prescriptions , does this not happen in USA
Bye

RisuNeko · Apr 11, 2015 at 04:25 PM

I pay copays at the pharmacy but my insirance which os free because im poor pays 99.9% of my med costs. I have the option of paying out of pocket if my insurance doesnt cover something but its usually too exoensive for me to do that, so i have to stick to covered meds.

RisuNeko · Apr 11, 2015 at 04:28 PM

I dont think the group insurance/ buying in bulk option exists in america or would even work with doctors. They dont want patients to have large quantities of controlled substances.

berthegel · Apr 11, 2015 at 04:44 PM

Hello
I sort of ment couldn't your insurance company give you the group policy,
But they also buy and then liase with your chemists ?
Like in UK you can get fully comprehensive car insurance where multiple drivers can drive the same car on the one insurance?
I don't really no the USA system medicare ??

RisuNeko · Apr 11, 2015 at 04:46 PM

I dont think.we have anything like that unfortunately.

berthegel · Apr 11, 2015 at 04:52 PM

Hello , I know its off the point a bit , but didn't Barack Obama get shouted down for trying to introduce a better healthcare system in US ?

RisuNeko · Apr 11, 2015 at 04:54 PM

Im actually only insured now because of so called 'obamacare'. I dont think universal health care is a bad thing. Especially since i dont have to pay for it.

berthegel · Apr 11, 2015 at 05:19 PM

Hello again , I've just been on wikipedia

Colleges have a sponsored student insurance thingy
But a quick glance at american health, it seems like if public health care becomes more popular the more it goes up in price

berthegel · Apr 11, 2015 at 05:38 PM

Hello ,
I'm prescribed propananol and amitriptyline
I find having something on my stomach helps _ especially bananas , I think the potassium in bananas helps mood and anxiety , it takes a while for it to digest,
I find if I'm nautious a banana is easy to eat
Or porridge oats is another good food

RisuNeko · Apr 11, 2015 at 05:43 PM

Thats funny because i ate dried banana chips today for breakfast, just a handful, but it really helped the nausea from my metformin. First time i havemt thrown up after breakfast in 3 days ( i jad been drinking protein smoothies and that did not mix well). Bananas help me with nausea after dinner at work too when i take my second dose of metformin. (I worl evenings where there is a kitchen i have access to, an assisted living house for the elderly).

berthegel · Apr 11, 2015 at 05:56 PM

Doesn't working at the old peoples centre qualify you for extra help with health insurance ?

Also , along with bananas , porridge oats ( we have "readybrek" in the UK you just add hot milk or there are microwave oat thingys) high protein foods like chicken , peanuts are recommended because of the way they fill you up for longer, and sultanas and raisins

RisuNeko · Apr 11, 2015 at 05:58 PM

No it doesnt help with health insurance. I could opt in to pay like 300$ a month for my companies health plan but why do that when im broke and get health insurance free through the state?

Im trying to lose 70lbs so i dont think oats are best for me but thanks for the tip.

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sideblinded Elder Member Since Jul 2014 Location: Iowa Posts: 5,331 9 3,940 hugs given	Apr 10, 2015 at 03:14 PM #2 Riso....I have quantity limits on my pills as well. My NP is smart to this problem. She prescribes a larger dosage and tells me to cut the pill in half so it last the whole month. Ask your prescriber to do this. If they won't, I would change doctors. Most insurances have quantity limits on certain medications. It is about supply and costs. Best wishes.
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Anonymous200325 Guest Posts: n/a	Apr 10, 2015 at 04:33 PM #5 I used to run into similar problems. Sometimes the pharmacy (Target) would use a prescription discount card (there are several available) to get around the pill limits. For generic drugs, the cost with the prescription discount card was often less than my insurance co-pay.
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raspberrytorte Insert Smiley Face Member Since Mar 2015 Location: USA Posts: 5,560 9 4,915 hugs given	Apr 10, 2015 at 07:52 PM #6 I've never heard of this before! That's sucky. __________________ The darkest of nights is followed by the brightest of days.
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berthegel Member Member Since Mar 2015 Location: uk Posts: 186 9	Apr 11, 2015 at 04:44 PM #12 Hello I sort of ment couldn't your insurance company give you the group policy, But they also buy and then liase with your chemists ? Like in UK you can get fully comprehensive car insurance where multiple drivers can drive the same car on the one insurance? I don't really no the USA system medicare ??
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RisuNeko Poohbah Member Since Mar 2015 Location: Portland, Oregon, USA Posts: 1,171 9 7 hugs given	Apr 11, 2015 at 04:46 PM #13 I dont think.we have anything like that unfortunately. __________________ Diagnoses: Bipolar I, GAD, binge eating disorder (or something), substance abuse, and ADHD. “No great mind has ever existed without a touch of madness.” ― Aristotle
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berthegel Member Member Since Mar 2015 Location: uk Posts: 186 9	Apr 11, 2015 at 04:52 PM #14 Hello , I know its off the point a bit , but didn't Barack Obama get shouted down for trying to introduce a better healthcare system in US ?
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RisuNeko Poohbah Member Since Mar 2015 Location: Portland, Oregon, USA Posts: 1,171 9 7 hugs given	Apr 11, 2015 at 04:54 PM #15 Im actually only insured now because of so called 'obamacare'. I dont think universal health care is a bad thing. Especially since i dont have to pay for it. __________________ Diagnoses: Bipolar I, GAD, binge eating disorder (or something), substance abuse, and ADHD. “No great mind has ever existed without a touch of madness.” ― Aristotle
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berthegel Member Member Since Mar 2015 Location: uk Posts: 186 9	Apr 11, 2015 at 05:19 PM #16 Hello again , I've just been on wikipedia Colleges have a sponsored student insurance thingy But a quick glance at american health, it seems like if public health care becomes more popular the more it goes up in price
	Reply With Quote

berthegel Member Member Since Mar 2015 Location: uk Posts: 186 9	Apr 11, 2015 at 05:38 PM #17 Hello , I'm prescribed propananol and amitriptyline I find having something on my stomach helps _ especially bananas , I think the potassium in bananas helps mood and anxiety , it takes a while for it to digest, I find if I'm nautious a banana is easy to eat Or porridge oats is another good food
	Reply With Quote

berthegel Member Member Since Mar 2015 Location: uk Posts: 186 9	Apr 11, 2015 at 05:56 PM #19 Doesn't working at the old peoples centre qualify you for extra help with health insurance ? Also , along with bananas , porridge oats ( we have "readybrek" in the UK you just add hot milk or there are microwave oat thingys) high protein foods like chicken , peanuts are recommended because of the way they fill you up for longer, and sultanas and raisins
	Reply With Quote