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Only one week of meds?

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Chronic Pain
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Posted 5/6/2019 5:03 PM (GMT 0)
So, this is new. Saw my PM today, she e-scripted as usual. Get to the pharmacy and they tell me they can only give me one weeks worth of my meds...that I'll have to get a 'refill' after a week...the remainder of my month supply. Seriously? This is getting on my nerves. My pharmacists are great...never give me a hassle about being a chronic pain patient, and feel really bad about this extra hoop I'll have to jump through. This is the new protocol from the insurance company.
Posted 5/6/2019 6:38 PM (GMT 0)
PM, I would call & verify this with my insurance company. I am guessing this will involve 2 co-pays too, which is just wrong in my book. I have read time a few times about pharmacies doing this, some insurance related, some not. Let us know if this is indeed a new thing with your insurance.

Hopefully this was just a glitch!!
Posted 5/7/2019 1:06 AM (GMT 0)
Wow! That's scary. Was it because it was a new med?
I thought my insurance was bad not allowing a 3 month supply of tramadol, but one of my nurses said that happened to her too.
I'd be interested to hear if this one week thing is going on all over.
Posted 5/7/2019 2:48 PM (GMT 0)
Susie, it's Medicare...good luck getting through to anyone! The pharmacist said the insurance company doesn't want anyone having that number of pills at one time. (150) This 28 cost me .79 cents. Label says 4 refills. Add it up and it's what I would have paid for them all at once, so it's fair. Just a hassle to have to run for them all the time.

Alcie, Tramadol is what I take. The script is written for 1 every 6 hours as needed for pain. It usually takes me 6 months or more to use them all even though it's a one month supply. I'll try laying down, doing yoga, using my heating pad or ice pack, taking ibuprofen, long before reaching for the prescription bottle. I'm not going to get better...only worse...so I'm trying to hold out as long as possible. The fact that it's so long in between scripts is the issue...each time she writes it, it is viewed as a 'new' prescription. If I want to avoid that, I'll have to get it filled more frequently...leaving me with a lot of pills on hand! Defeats the purpose of what Medicare is trying to do!
Posted 5/7/2019 7:55 PM (GMT 0)
If I am understanding correctly, Medicare says a 30 day script of your medication is too much to fill. Instead you are allocated 7 days worth, then you get the remaining monthly script? That makes absolutely no sense at all. Glad to see there are not 2 co-pays involved, but you are right about the inconvenience to this mess!
Posted 5/7/2019 8:44 PM (GMT 0)
The order in which you must go to obtain pain meds exactly mirror's the CDC guidelines they are now saying is being wrongfully administered.
Posted 5/10/2019 8:15 PM (GMT 0)
Do you see a Pain Management Doctor? Does your insurance company know your opiates are for chronic pain ?


It sounds like your insurance company thinks the rx is for acute pain. Unfortunately., this is a common mistake. It happens mainly when the prescribing doctor is not a pain management specialist.

Several months ago a physical rehab doctor filled in for my pain doctor. Even though I have been getting the same medication every 30 days for years. Medicare said they had to talk to the doctors office to verify it was for chronic pain. It was late in the evening and the office was closed. I paid for the prescription. My state has,a,law,restricting rxs for acute pain to 7 days.

Post Edited (Mercy&Grace) : 5/10/2019 2:18:21 PM (GMT-6)

Posted 5/11/2019 3:19 PM (GMT 0)
Mercy & Grace...yes, the script was from my pain management doctor. Yes, it is a med I have been prescribed for chronic pain many times in the past. "Problem" is...I don't take it every 6hrs...I take it very, very sparingly. Because so much time passes before I need a new script...they are viewing it as a 'new' prescription.

Now, I have 2 choices. Go back to my PM every month for a new script, even though I don't 'need' it and stockpile prescription bottles OR go through this each time I actually need more meds. Sigh.
Posted 5/12/2019 3:24 AM (GMT 0)
Since you do not take it daily. It might not be considered for chronic pain. If your doctor contacts the insurance company and explains it. That may or may not make a,difference. Did your doctor put the code for chronic pain on your rx ? Or did he write it was for chronic pain on the rx ?
Posted 5/12/2019 4:06 PM (GMT 0)
MG, I've no idea what was written...it was e-scripted. The directions are one every six hours as needed for pain.
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