Reply to dye-free amoxicillin not covered by insurance

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Reply to "dye-free amoxicillin not covered by insurance"

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[quote=Anonymous]After some experimentation, we have determined that the red dye in children's amoxicillin makes my daughter go completely nuts. So I located a pharmacy that could mix up a dye free batch (from a different generic lab). We have Anthem insurance, and generic prescriptions are supposed to be $10, but the pharmacy charged us $20.99. They didn't tell me ahead of time that it would cost more, and I was short on time at pick up and couldn't wait around for someone to explain the charges. At home, I logged on to our insurance portal and it appears that our formulary only covers one generic lab's product (Dr. Reddy's lab), and this is the preparation with the red dye. The dye-free is manufactured by West-ward labs. I didn't know formularies got that specific. The pharmacist even made a note on the script that DD is allergic to red dye. Has anyone else had a similar experience? What did you do? It looks like there may be a way to request a preauthorization for non-formulary medications, but the website is aggravatingly vague on the process. DD is only 3, so I can expect many, many scripts for amoxicillin in the years to come and I would like to cut our expenses if I can.

FWIW, the prescription plan is also denying us coverage for DD's compounded Prevacid. They cover the capsules, which make a terrible compound, and Prilosec powder. And that's it. So we are switching to Prilosec because otherwise we'll be forking over $160/month. I am beyond frustrated and not sure where to start. I called Anthem directly, and they told me to talk to the pharmacist to price other options. The pharmacist says they need an actual script to do that, because of the way compounding works (they need to figure out how much powder would be used). I finally found our formulary list online, and I sure hope they really will cover the Prilosec powder, because I'm not sure what to expect out of the appeal process.[/quote]

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