Insurance Co. Trying To Reject Prescription Refill
 

Hello out there.

I have been taking Endocet 10/325 for B.T. pain for over 1 & 1/2 years now. I take up to 8 a day if needed. Now all of a sudden my Ins. Co. is sending to my pharmacy a reject message that says Tylenol max strength 500mg/ day exceeded.

The pharmacist called my PM Dr. about this matter and after talking to the Dr. the Ins. allowed it to go through.

Has anyone else run across this same problem.

This is a common problem. Its happened to my wife many times, especially pertaining to generic opposed to name brands which often are much better meds than generics. By the way I have a disdain for heath insurance companies, so I'm biased right off the bat. I also think much more attention needs to focus on bad generics that don't even come close to the name brands as far as effectiveness. To me, it's money grubbing greed.

The new FDA actions regarding Tylenol are beginning.

I think the insurances are just following suit... The FDA may pull all combo products eventually, but that is a long process and if doctors protest they may not. Also in the works is removing 500mg extra Strength Tylenol products from OTC shelves, and also mixtures in cough/cold products containing tylenol.

These kinds of actions tend to take time.

bck when i was taking percosett i use to have my doctor write it without the tylenol because i didnt want all the extra junk in my liver...you can alwas take tylenol on your own if you need it.
just a thought

This problem is on the rise
 

It doesn't matter who you've got as far as insurance coverage for medication, we'd all better hang on tight since this problem is not only getting worse today, it's going to get a whole lot worse tomorrow.

Be it Medicare Part D, private insurance or Medicare, every insurance company has limits on a slew of medications that would take me hours to list. For example a person who's on OxyContin and who's on Medicare Part D can only get a maximum dosage of 120mg per day. In my case I happen to be on 160mg so that means I either live with less or I pay the difference. In this case, the difference in 40mg more of OxyContin per day adds around $150 or more onto my refill cost that already has a rather steep co-pay up front each month. In my case I'm still covered through my previous employer, though the premiums are enough to choke a horse, the fact that they will cover the 160mg dosage makes this monthly watershed one I accept since I'm able to get the dosage my doctor is prescribing.

Last year Medicare Part D offered around 61 different prescription plans. This year there were only around 45 plans on average available depending on where you are living in this country. Expect the drug plan options available to dry up at the same rate we're watching the rates increase yearly even though Part D is actually covering less drugs and their dosages more each passing year.

My heart goes out to you but like it or not we're all living 3rd class and we're on the Titanic. A few actually made it to shore, but this is a sinking ship and a trip we can't get off of. Now I wonder why more people are looking at alternative solutions? I'd never cast a stone for those whom are. Only those who walk in our shoes understand why it's like living with chronic pain 7/24. Problem is we've got bureaucrats making health care decisions that affect us yet they don't have any idea about what it's like living in our bodies. Maybe it's time we pass that 29th constitutional amendment after all - where the senate and congress have to live by the same laws and rules they impose upon us? My best wishes this is a battle you'll win.