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Raising Special Needs Kids Raising Special Needs Kids

So frustrated!

Posted by on Sep. 15, 2012 at 2:52 PM
  • 7 Replies

Lately it seems like everything keeps coming at us. Right now though I am so frustrated with insurance. Our neurologist wants ds on keppra, not generic. But neither our insurance or medi-cal covers the name brand. So I have to call down to her office Monday, and see what she wants me to do.

She did give us a discount card for Keppra, but it doesn't work because ds qualifies for medi-cal. UGH!!!!


Hope you ladies are having a good weekend!

by on Sep. 15, 2012 at 2:52 PM
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Replies (1-7):
jjamom
by Michele on Sep. 15, 2012 at 3:24 PM
I thought that if the physician writes "brand specific" on the prescription they had to cover it? My neuro did this for me because the generic of a specific med didn't come in the correct dose and couldn't be split b/c it was a coated pill. My insurance covered it then. Also my neuro told me that she doesn't believe all generics are equal to name brand meds and thus if it is specified "brand specific only" they have to cover it. I could be wrong, though.
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Mipsy
by Chelle on Sep. 15, 2012 at 4:14 PM
Yeah I thought if they specified brand specific they had to give it? We've been lucky that the generics have been fine for Ty
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sammygrl77
by on Sep. 15, 2012 at 4:56 PM
How frustrating! I've had one time where a medication had to be approved. It took a few days. Hope it gets fixed.
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darbyakeep45
by Darby on Sep. 15, 2012 at 4:57 PM

I'm sorry Amanda...hugs mama!  Good luck!

mandee1503
by Amanda on Sep. 15, 2012 at 5:25 PM
If she doesn't change it to depakote she'll have to write a letter to the insurance company.

Quoting jjamom:

I thought that if the physician writes "brand specific" on the prescription they had to cover it? My neuro did this for me because the generic of a specific med didn't come in the correct dose and couldn't be split b/c it was a coated pill. My insurance covered it then. Also my neuro told me that she doesn't believe all generics are equal to name brand meds and thus if it is specified "brand specific only" they have to cover it. I could be wrong, though.
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mandee1503
by Amanda on Sep. 15, 2012 at 5:27 PM
She'll have to write to the insurance companies.

Quoting Mipsy:

Yeah I thought if they specified brand specific they had to give it? We've been lucky that the generics have been fine for Ty
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jjamom
by Michele on Sep. 15, 2012 at 6:16 PM
Quoting mandee1503:




I would have her write the note. She can provide medical necessity for the specific med and then they should approve it. Good luck! I hate dealing with insurance about coverage issues. :(
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