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Posted 3/4/2009 4:55 PM (GMT 0)

I have a question to ask...My insurance won't cover my methadone...this I already knew, but I have another script for Roxicet 15mg. for 120.  My insurance will only cover 80 of them?  That is such an odd number I was wondering if anybody might know the reason for that number?

Me. confused

Posted 3/4/2009 5:48 PM (GMT 0)
I would ask the pharmacy whats up with that..Susie
Posted 3/4/2009 7:52 PM (GMT 0)
Who knows? Insurance companies are weird like that. Call your insurer & ask them why only 80 and whether they will cover more if it is determined to be medically necessary. Sometimes they will allow a higher amount if they just get a short letter from your PM stating what's wrong with you & why you need more meds than 80/month.

best wishes,
frances
Posted 3/10/2009 2:20 PM (GMT 0)
Yes, I think I will talk to my PM and see if they know why? Thanks

Me.
Posted 3/10/2009 2:51 PM (GMT 0)
I have Blue Cross<>Blue Sheild and usually get qty-120 x #15Oxies a month & 90 x #10 Methadones a month and they never said a word. Can you find Oxicodone #15 where you live? My Doc gave me Perc #10/325 again yesterday because they said no one had the Oxie's yet????
Good luck w/ your Insurance Co. I like the idea of a letter from Doc too!
Huggs,
Pete
Posted 3/10/2009 5:18 PM (GMT 0)
Cant answer for you but can tell u taht today i tried to fill my zolfran and i was told by my pharmicyst that BCBS will only cover 21 pills per month.....WHAT????
Posted 3/10/2009 6:47 PM (GMT 0)
Your insurer won't cover Methadone!! They are making a big mistake there. Methadone
is one of the least expensive (and most effective and least harmful) of all the
Opiods. They are dum dums. tongue
Pamela
Good luck, Me
Posted 3/10/2009 6:57 PM (GMT 0)
Shannon,
Sometimes the number of pills can be affected by the diagnosis that's given. I don't know that much about this medication, but I wonder if it's given for shorter term problems, and unless the doctor's office gives specific instructions you can only get it for a short period of time? I'd call your pharmacist and ask if they know anything - is the medicaiton prescribed for different things. And maybe your doctor's office needs to intervene.

Just a thought. Maybe someone else here knows more.

PaLady
Posted 3/10/2009 9:29 PM (GMT 0)

Hey Pete,

I had to get the Perc 10's last month due to the recall on oxycodone. This month I didn't have any problems getting the oxycodone 15mg.  But my insurance would only cover 80 of the 120.  And it won't pay for my methadone.  It used to a few years ago, but not any more....

Crazy, huh?

Me.

Posted 3/10/2009 9:35 PM (GMT 0)

Pamela,

Yes they are dum dums...Methadone at a clinic for maintainence treatment is very costly.  To go to a Methadone clinic it costs $360 each month to get up to 120 mg. each day.  It costs the same no matter what your dose is... Methadone from a Dr. and getting it at the pharmacy costs me $60 a month for 360 pills.  Talk about a giant rip off!!! nono

Those clinics are making a fortune off of people's misery.  And I don't understand why TennCare won't cover methadone but it will cover morphine, oxycontin, and many other more expensive narcotics...Go figure.

And...not all pharmacies even have methadone...Krogers won't carry it at all.  And some of the pharmacies run out so I have to go from pharmacy to pharmacy just to find it.

I'm going to talk to my doc about getting something stronger then the oxycodone 15mg. for BT pain.  They will only cover 80 of them so I might as well get something better anyway...

Me.

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