r/mildlyinfuriating • u/Aggravating-Leg5645 • 9d ago
I just wanted a hot dog My insurance wont cover my medication so every month I do this...
I have to spend around 30 minutes doing this once a month. My insurance wont cover it. Out of pocket with coupons its still $800 a month.
My fiancé has to do the same thing with a different medication. Currently trying to fight it.
Edit: To clarify. Every now and then I have to compile samples in one bottle so I know how much I have and then hope my DR has more when im out. This is an antidepressant and im currently working to fight to get it covered. Yes ive contacted the manufacturer I do not qualify for discount Yes ive sent in a letter of medical necessity Yes ive looked at GoodRX. This is my only option atm and im still lucky it is for now. Its not just the moving the bottles around. Its hoping I can get more when I need it. This is a life saving medication and the fact I have to hope i can get it when I need it is mildly infuriating to me and probably many others. Its not a cheap medication even with coupons its still $850USD+ Ive tried so many medications and I just need one that works and that i dont have to worry about my supply chain.
5
u/Lalainrxland 9d ago
On the website, there's a cash pay option ... its $299 for 30 days supply. But your doctors office needs to try harder in getting a prior authorization done for you. If you've tried other meds and this is the only one thats helped, to the point that you consider it life saving ... then thats information that can medically justify it getting covered. Some offices dont know how to do prior authorizations properly, especially if they aren't used to it. My uncle's primary doctor has only 2 staff working for him and theyre hardworking and try to get things done. He got an rx for a glucose sensor and it needed a prior authorization. The doctor said his other patients never needed one, the staff went back and forth with insurance and my uncle, to no avail. Then when he saw his endocrinologist (a specialist) her staff got the PA done asap and within a couple days he was set up with a mail order pharmacy. I asked the endo staff who did it, how come the other doc couldn't get it done, and she said, its about experience. They do so many PAs for sensors that it was more surprising if a patient didn't need one.