[mrm3601]

This goes beyond Parnate.

My psychiatrist has prescribed 80mg of Parnate when my insurance company will only approve up to 60mg. My doctor and the pharmacist are trying to get this approved and I'll find out what the bottom line is within a few days.

If my insurance does not approve the 80mg dose then I'll be faced, I think, with either taking 60 mg or paying out of pocket for the extra.

I know this applies to other people and to other medications. My question is:
has anyone experienced this sort of thing? If so, how was it resolved?

[deliquesce]

i'm not in the US, so i dont understand insurance things.
but i was wondering if maybe adding a second drug (a mood stabiliser?) could be an option to help you out?
i am on 15mg of Parnate and reluctant to go higher because i have highly allergic reactions to even the slightest trace of tyramine. my psychiatrist has said we can augment it with Lamictal or similar, if i need more down the track. i've been on lamictal before and it was pretty good for depression, but obviously not enough on its own.

[mrm3601]

Thanks for your response. In fact, my psychiatrist proposed to add Provigil to the 60 mg Parnate amount he's had me on. I told him "no," at least not for the moment, because I wanted to him more seriously consider raising the dosage of Parnat to 80mg, which, as I've said, he's trying to do.

I'm aware that different adjuncts are used with Parnate but that's not my primary concern right now. As I say, I'm more interested in people's experiences with their insurance companies covering, or not covering, prescription medications.

Originally Posted by deliquesce

i'm not in the US, so i dont understand insurance things.
but i was wondering if maybe adding a second drug (a mood stabiliser?) could be an option to help you out?
i am on 15mg of Parnate and reluctant to go higher because i have highly allergic reactions to even the slightest trace of tyramine. my psychiatrist has said we can augment it with Lamictal or similar, if i need more down the track. i've been on lamictal before and it was pretty good for depression, but obviously not enough on its own.

[Catherine2]

Jme, from both sides of treatment...

Initial scrip was denied, so we filed an appeal. While waiting for the appeal to be reviewed, the prescribing pdoc kept me in samples to meet the dosage we wanted...my pharmacist was also instrumental in getting it approved.
The number one reason it was approved? Cost. It was more cost effective to approve the increased dosage than to add any adjunct...
But we also included every snippet of info about my medical conditions and possible interactions with my maintenance drugs, previous no response to different classes of drugs--well, basically every little bit we could legally and ethically use to make our case.

It took five weeks, but it was approved. I don't give up easily, and I don't think you will either.
Details, details, and everyone on the same page made it possible.

Catherine

[possum220]

In Australia, due to Medicare most medications, if you are receiving government subsidies, (ie pensions or newstart allowance) cost $5:70. However if you are prescribed a medication not deemed to be linked with your illness you will pay the full price. For example I use the medication Seroquel. Because I do not have schizophrenia or bi-polar (and using lithium or sodium valproate) then I must pay $200 per month.

Another drug Klonolpin/Paxam has been deemed by the govt to only be subsided should you have epilepsy so I have to pay full price for that also. Thankfully that is only $30. Insurance doesn't come into it.

http://forums.psychcentral.com/showthread.php?t=114350

[mrm3601]

Good for you, Cathernine2.

As it has turned out, so far, I picked up a script for Parnate at 60 mg, not the 80 my psychiatrist prescribed. But I won't let this go. I'll be in touch with both the psychiatrist and the pharmacist and we'll see what happens.

I'm sure most know that the major pharmaceutical companies have "patient assistance programs" (PAP) for those who can't afford the prescriptions on their own. One catch, however, is that for those who have Medicaid the costs run a bit more than if one had no insurance at all. Also, the Partnership for Prescription Assistance (http://www.pparx.org/) is available in most states to help folks cover the cost of prescription medications.

This, in light of the health care reform debate that currently rages in the USA.

Originally Posted by Catherine2

Jme, from both sides of treatment...

Initial scrip was denied, so we filed an appeal. While waiting for the appeal to be reviewed, the prescribing pdoc kept me in samples to meet the dosage we wanted...my pharmacist was also instrumental in getting it approved.
The number one reason it was approved? Cost. It was more cost effective to approve the increased dosage than to add any adjunct...
But we also included every snippet of info about my medical conditions and possible interactions with my maintenance drugs, previous no response to different classes of drugs--well, basically every little bit we could legally and ethically use to make our case.

It took five weeks, but it was approved. I don't give up easily, and I don't think you will either.
Details, details, and everyone on the same page made it possible.

Catherine

[Catherine2]

Thank you for putting those links in your post...
A few years back it was necessary for me to use these programs, however I did use
http://www.needymeds.org/
It is like the gateway to most of the available programs.
I found the people I talked to were professional but concerned and determined to help in every way they could...

Best wishes for getting the increased dose of Parnate approved...being prepared will be of help and it sounds like you are getting things in place.

In my thoughts for the coming week,
Catherine

[phoenix47baby]

MRM,

Call your member services department and have them phone your doctor. Typically after the doctor explains things, more medication is prescribed. In the event that it is not, there is an appeals process that you will have to go through. Unfortunately that could take some time. Is there anything that your doctor can add to the Parnate? Stay on top of your insurance company and make sure your doctor is being proactive with them. You will eventually get it resolved. Good Luck!

[mrm3601]

Thank you, phoenix47baby, but the issue has been resolved, due in large part to my psychiatrist.

Originally Posted by phoenix47baby

MRM,

Call your member services department and have them phone your doctor. Typically after the doctor explains things, more medication is prescribed. In the event that it is not, there is an appeals process that you will have to go through. Unfortunately that could take some time. Is there anything that your doctor can add to the Parnate? Stay on top of your insurance company and make sure your doctor is being proactive with them. You will eventually get it resolved. Good Luck!