How to appeal for medication

[Foamer Pyle]

I was wondering if anyone has had to appeal our insurance for a medication. I take nexium 40 mg every day, and now there is a generic out, so they will not pay for the brand name anymore. 99% of the time I am fine with generic, but this time it does not work for me, something is different. Nothing worse than getting heartburn every time you eat. I have tried all of the other meds on the market, and nothing works as well for me than Nexium. When I went to CVS last week for my refill they said "that will be $334.00 please." Anyway, if anyone has had success with being able to make an appeal for a medication, I would like to know how to go about it.

 

[UpstateNYUPSer(Ret)]

I was wondering if anyone has had to appeal our insurance for a medication. I take nexium 40 mg every day, and now there is a generic out, so they will not pay for the brand name anymore. 99% of the time I am fine with generic, but this time it does not work for me, something is different. Nothing worse than getting heartburn every time you eat. I have tried all of the other meds on the market, and nothing works as well for me than Nexium. When I went to CVS last week for my refill they said "that will be $334.00 please." Anyway, if anyone has had success with being able to make an appeal for a medication, I would like to know how to go about it.

Would they cover the meds if your doctor specified on the script that you must take Nexium 40 mg and then checked the box DAW-----dispense as written?

 

[cosmo1]

I was wondering if anyone has had to appeal our insurance for a medication. I take nexium 40 mg every day, and now there is a generic out, so they will not pay for the brand name anymore. 99% of the time I am fine with generic, but this time it does not work for me, something is different. Nothing worse than getting heartburn every time you eat. I have tried all of the other meds on the market, and nothing works as well for me than Nexium. When I went to CVS last week for my refill they said "that will be $334.00 please." Anyway, if anyone has had success with being able to make an appeal for a medication, I would like to know how to go about it.

Ask your doctor to call your carrier and explain the situation. My wife just went through that for her BP meds.

 

[Foamer Pyle]

Ask your doctor to call your carrier and explain the situation. My wife just went through that for her BP meds.

I will look into that. I know there has to be a way to get them to cover this. I have been taking Nexium for a good 15 years.

 

[Indecisi0n]

If the doctor specifically writes on the script that you need name brand they will cover it.

 

[UpstateNYUPSer(Ret)]

Would they cover the meds if your doctor specified on the script that you must take Nexium 40 mg and then checked the box DAW-----dispense as written?

If the doctor specifically writes on the script that you need name brand they will cover it.

 

[Loyal Teamster]

I was wondering if anyone has had to appeal our insurance for a medication. I take nexium 40 mg every day, and now there is a generic out, so they will not pay for the brand name anymore. 99% of the time I am fine with generic, but this time it does not work for me, something is different. Nothing worse than getting heartburn every time you eat. I have tried all of the other meds on the market, and nothing works as well for me than Nexium. When I went to CVS last week for my refill they said "that will be $334.00 please." Anyway, if anyone has had success with being able to make an appeal for a medication, I would like to know how to go about it.

Vote for Bernie Sanders, issue solved

 

[Foamer Pyle]

Vote for Bernie Sanders, issue solved

Then the government would tell me why I was not eligible for the medication.

 

[UpstateNYUPSer(Ret)]

Then the government would tell me why I was not eligible for the medication.

No, they would have you pay for your medicine and then give it to someone less fortunate.

 

[toonertoo]

Carry baking soda. Mix it with water. Biggest belch you will ever experience, no side effects. Good for your digestion and stomache lining. 99 cents. Heartburn gone

 

[Foamer Pyle]

Carry baking soda. Mix it with water. Biggest belch you will ever experience, no side effects. Good for your digestion and stomache lining. 99 cents. Heartburn gone

That's sounds funny, but I wouldn't try it. I had an ulcer in my 20's, and my gut hasn't been the same since. I have tried many different ways to get off that medicine, and nothing ever works.

 

[wayfair]

ask your Dr. about Pantoprazole... wonders I tell ya

 

[wayfair]

Carry baking soda. Mix it with water. Biggest belch you will ever experience, no side effects. Good for your digestion and stomache lining. 99 cents. Heartburn gone

too much sodium for hi Bper's out there

 

[Indecisi0n]

That's sounds funny, but I wouldn't try it. I had an ulcer in my 20's, and my gut hasn't been the same since. I have tried many different ways to get off that medicine, and nothing ever works.

Have you had your prostate checked recently ?

 

[1BROWNWRENCH]

Carry baking soda. Mix it with water. Biggest belch you will ever experience, no side effects. Good for your digestion and stomache lining. 99 cents. Heartburn gone

called "Liver Sauce" in the UK I believe. Loud farting too.

 

[toonertoo]

too much sodium for hi Bper's out there

Did not know

 

[Foamer Pyle]

Have you had your prostate checked recently ?

I know you are probably joking, but I get that done every year. Anyone that doesn't take that serious, will feel real stupid when they wind up terminal cancer, that could have been prevented by an annual check up.

 

[Indecisi0n]

I know you are probably joking, but I get that done every year. Anyone that doesn't take that serious, will feel real stupid when they wind up terminal cancer, that could have been prevented by an annual check up.

I am a little over protective. I get it check every Saturday night.

 

[toonertoo]

That's sounds funny, but I wouldn't try it. I had an ulcer in my 20's, and my gut hasn't been the same since. I have tried many different ways to get off that medicine, and nothing ever works.

I had acid reflux. Couldnt eat corn flakes, and go unload trailers at 3am. Doc said, no coffee, chocolate, or alcohol. I bought soda.

 

[barnyard]

Back on topic....

You have to have your Doctor write a letter to your insurance company that states why he is prescribing the name brand over the generic.

My wife was successful on getting a couple of things covered for our daughter. Both took 3ish months to wind their way through the system.