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dreamingneonblack

Getting insurance to cover un-covered liquid suspension

6 posts in this topic

I'm just curious if anybody has ever attempted to contest an insurance company for not covering the liquid or brand name form of their  ssri? I'm considering attempting but I don't know that it will be worth my efforts, even in terms of savings. Even if I decide to stay on liquid paxil without insurance, it will be costing me around $1500 a year :/ I'm really just trying to avoid the impending withdrawals of switching back to generic tablets and also having to make sure they don't switch manufacturers on me.

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Yah......I had good luck once getting the same stuff I wanted........not on my own though.......the prescribing Dr. had to go to bat for me and fill out paperwork and of course there was a wait..........  I think that it's possible that alot of Dr's do understand that the different versions of the same medication can have different effects on us.  Good luck.  My experience was years ago.......I wanted to stay on Lexapro rather than switch to Celexa and it happened.  So......not exactly the same......similar though.

 

I'd suggest calling the insurance company and finding out what hoops you have to jump.  And being patient with the process.  And having a Dr. on board.

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Thank you many! It gives me hope to hear that. The first hurdle that I will attempt tomorrow is just getting my dr to agree to this. Keep your fingers crossed for me

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I was switched from brand to generic by insurance without my knowing apor my dr knowing, I called the insurance directly telling them I got severe reaction to the generic and got very sick from it. They did right away.

 

As for liquid, you can also tell them you tried making liquid yourself but got serious problems as it doesn't provide accurate MG.

 

Insurance definitely would try not involve in any legal situations so they tend not to ignore such requests.

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The prescribing doctor has to make an argument that 1) a substitute drug would have an undesirable effect; or 2) a dosage is required that cannot be fulfilled with available tablet sizes; or 3) both.

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I asked my doctor to file a Treatment Authorization Request for the liquid and miraculously, my insurance company covered it. Probably because the compounding pharmacy is using generic tablets to make the liquid, but I'm still shocked. Good luck!

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