Reply to United Healthcare not covering certain ADHD meds

Forum Index » Kids With Special Needs and Disabilities

Reply to "United Healthcare not covering certain ADHD meds"

Subject:

Emoticons





More smilies

Text Color: Font: Close Marks

[quote=Anonymous][quote=Anonymous]hi.  I work for an insurer in pharmacy.  just because it is off formulary doesn't mean you can't get it.  2 options.  pay full price (but still get a discount) or appeal.
often you can get coverage with proof that other meds failed etc.

[b]you can thank the endless amount of people over prescribing and over utilizing these meds for putting you in this position.[/b]

if they allow all the drugs the abuse and fraud in this class is insane.  some controls for cost and overuse just have to be put in place sometimes.  if your child really needs one particular drug and there is doctor and rx history, it should go through.
[/quote]

This hasn't been my experience.  I wrote in another thread that my insurance company refused to cover Strattera (non-habit forming and non-stimulant) before I tried Vyvanse (a stimulant).  Why?  Because Vyvanse was shown to be "more effective."  All of these decisions by insurance companies are based on the bottom line, not out of any concern from abuse (though certainly it is the case that people abuse ADHD stimulant medications).  Strattera would have been more expensive for them to cover, I am sure, both in terms of whatever cost from supplier as compared to Vyvanse and perhaps also additional appointments with my psychiatrist, since you need to check in more often at least in the beginning when you are slowly upping the med.   [/quote]

Options

	Disable HTML in this message
	Disable BB Code in this message
	Disable smilies in this message

Review message

Search Recent Topics Hottest Topics