Why would medicaid turn down my Abilify prescription?

So I am on (and weaning off of) Invega...while im weaning off my pdoc told me to start taking Abilify...I went to the pharmacy and they told me my insurance is denying my abilify and they will have to contact my doctor.

My only geuss is that they are wondering why I'm taking two high end anti psychotic drugs? Does abilify have a generic? Would it be better asking for that?

I worried b/c I dont want them to keep denying my new prescriptions

Abilify is yet another expensive psych med. Most state medicaid programs do only allow X amount of "brand named" expensive meds. This is common.

The generic Abilify was approved April 28,2015... Its possible your Pdoc just needs to fill out exception forms. Medicaid does often request that certain meds are tried before allowing others.

I have a friend, her husband is on numerous breathing medications and its always a juggle to find adequate medications that help his severe problems , he is on Oxygen 24/7 . but Medicaid still has many med restrictions for him, and limits on brand names.

Was medicaid paying for your Invega? That one does not have a generic version and is expensive. I took it before, I have great drug insurance thankfully but out of pocket would have been almost 1000.00 a month

Medicaid needs to pre-approve abilify. It's a simple thing where your Dr has to say why two of there approved antipsychotic didn't work. They can still deny you but its not likely. I moved states and they wouldn't approve my script because I didn't try two things in there state. Now I'm fighting them for the abilify shot because the pills weren't working well.

Interesting! Thank you for the replies! Hopefully they will approve it. I am going to give my pharmacy a call and see

Good luck Lynizle, I hope they approve it.

Thanks called the pharmacy and they said that they havent heard anything from my doctor..they said the docs are usually really bad at getting around to this stuff...so geuss im probably going to be waiting for awhile lol

Call your Dr and tell them your waiting for pre aproval

Woohoo. Was approved. Ty again

Another term the pharmacy and insurance "must" honor by the doctor is "medically necessary". As if that isn't obvious, for what doctor would order a particular medicine if it wasn't medically necessary for the patient?