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I just went back to the doctor in person get my refill. She gave me a year of refills of 20 at a time as needed for incredibly aweful migraine relief. When I picked up my prescription, the pharmacist informed me that the insurance company only covers this particular medicine once. And only 9 pills at that time. If I need more I have to go back to my doctor and ask them to write a letter requesting the medicine on my behalf and explain why I need it. The insurance company will make a decision based on that........ I have Premera Blue Cross insurance through work. It looks like they cut up samples and put them in a plastic ziplock bag. Cost me $10 with co pay. I asked how much if I just wanna buy the pills on my own. They cost $30 apiece and you may take up to 8 per migraine...notice below the 9/20 quantity it says I have 11+ refills left for this because I actually do need a lot more than 9 of them.... ********** Received letter from Insurance relating to this medication which reads:***************** Dear Member, We want you to have the best health care possible. One of the ways we do that is to support your doctor by watching trends and best use of prescription drugs. From that, we establish recommended guidelines for treatment with various drugs Our pharmacy claim records show that you have been taking more than the recomended amounts of your migraine medication. Coverage of these medications is limited to recommended amounts. We let your pharmacist know on 07/27/09 that your prescription for Imitrex exceeds the guidelines for recommended amounts. We allowed you a one-time 2 day coverage exception, so you could get your medication. Clinical studies indicate that: Many patients who relieve migraine headaches with medications may also benefit from taking drugs that help prevent or reduce the number of headaches, and Patients should have a follow-up meeting with their doctor to make ongoing treatment decisions. Before we can continue to cover this medication under your pharmacy benefit, your doctor needs to fill out these forms (attached). If you prefer, you can have your doctor call us at 888-261-1756 to get the forms. Then the two of you will decide if you need to stay on this medication or adjust it. If your doctor wants you to stay on it, we will need him or her to fax a new "exception request" to us at 888-261-1756.
By: lwolfe26 Copyright © All Rights Reserved
Taken: July 7, 2009
Uploaded: July 7, 2009
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