DH's new health insurance through his job is majorly screwing us.

He has epilepsy and the drug he take is Lamictal. In August of last year the medication went generic. He gladly went on it in Sept, thankful for the lower copay. Well he started suffering grand mal seizures again in late Sept/early Oct, one causing a major injury(fractured vertebra)

He had about 1-2 a month until Feb when the doc gave him a DAW prescription for brand name Lamictal...only one small partial seizure since then. Our old insurance had no problem with it as long as it was approved by the doc for a medical reason.

We went to fill it last week and the new insurance is refusing to cover and in the fine print of the pharmacy section it says if a generic is available brand name will not be covered regardless of medical need or reason.

We are in the process of fighting this but DH NEEDS his meds and it is $800 a month to pay. Something we absolutely CANNOT do.

I found this program called "bridge to access" on the GlaxoSmithKlien website that says it will give him 60 day supplies for $10 if his insurance wont cover him. There are income guidelines that we fall WELL under but I just wanted to know if ANYONE has ever been through the process. It seems WAY too easy. All it is is filling out a form, taking it to the doc and having them fill it out and faxing it in, you can go get your first 60 days that same day at a local pharmacy and the rest is filled by mail, you call in refills 3 weeks before you need more... Could it be possible for it really to be this easy?


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Comments:

livewell
Mar. 13, 2010 at 8:00 PM

This is really old but I wonder how it went? Did you have any issues with them?

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Super...
Mar. 13, 2010 at 9:02 PM

We had all the paper work ready and he was approved , we were on our way to pick up the paper work to get it filled and at the last minute his regular insurance called and said they decided to pay for it.

But it was really that easy. I could not believe it

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