Can any allergy parents help me troubleshoot this situation? Just tried to refill my kid's epipen prescription and CVS said my insurance only covers one epipen per 30 day period and recommended I call my insurance company for an insurance override.
I am confused, because an epipen is not a monthly medication--if you use it, you immediately need another. My insurance has always covered as many epipens as needed, and you all know, you need at least two at a time for school and home. Who do I contact? My kid's allergist to get the prescription written as an "as-needed" prescription? The insurance company for an override? Call CVS back and hope to find a more knowledgable clerk? |
If CVS said to call your insurance that’s where I’d start. My insurance has a number for prescriptions. |
You might have to pay out of pocket for your second one depending on your plan. But yes, call your insurance provider to ask. Has this ever happened before? |
How many times a month are you injecting your child with an epi pen? |
Épi pens don’t really expire (according to a pharmacist friend) so keep the old ones until you can get enough new ones to replace them. |
Are you no longer getting a dual pack with true EpiPen ™️ ?
I’d try to have the prescriber write for EpiPen duo - Mom in school health with 2 DC who must carry epinephrine. Also learned years ago that YOU MUST have two - one epi administered ideally for rescue to arrive but second given within 15 minutes IF symptoms worsen AND rescue hasn’t arrived. In other words, one epi should last long enough for help to arrive or to get to the ER. I’ve given one DC two epipens TWICE! |
Not an acceptable strategy if school needs the replacements. They will only take non-expired pens. |
Need 3 at start of school year: one for school, one for SACC, and one for home. I typically have to wait 30 days for my one for home. |
We've had this exact same issue. As people said, often need multiple sets for home school etc. We've paid out of pocket when needing more than one set in a month. |
How frustrating! This sounds like it might be specific to your insurance. I've never had a problem getting multiple packs at once on BCBS. As others have said, they come in a pack of two. So one rx should cover you for one setting (e.g., school). Then you can wait 30 days and get another pack for home or camp or whatever. Another option would be to look into getting an Auvi-q. You can order it direct from the manufacturer with a prescription. $150. Not sure how that compares with out of pocket cost of Epipen. I always get an Auvi-q for home because it's easier to use and I am squeamish about jabbing my kid with a needle. |
Why do you need so many? They don't expire after a month. Try to be diligent and avoid allergens requiring the use of the pen. We have gone a year a more without needing it for our kids. We collect the pens, we all carry one.
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Seems outlandish that you need more than one a month. What is going on ? |
NP. But to the posters who are asking why you need more than one Epipen, your ignorance is showing. A child with a history of anaphylaxis should have an Epipen available at 1) school; 2) home; 3) aftercare; 4) home of any other regular caretaker (e.g., grandparent). Every summer, we stock up on new Epipens as part of back to school prep. And we sometimes need to get new ones for summer camp too, depending on expiration dates. The hope is that they will never have to be used. But they need to be available just in case. |
Then, ask for an override or get one every month which will be 12 a year. |
BCBS definitely limits the number of epi pens. Yes, the AuviQ comes in a pack of two — but guess what? The school needs BOTH. I also had to wait a few weeks to order my “home” set of epi pens. |