Wellness

[BalletBabe]

What's funny is I could order what I was taking.  It don't require a RX.   Since they classified it as  tier 4,  I was paying 70.00 for a 90 day supply. I can order a 90 day supply for 90.   I am noot going to but I will if I have to.   This is not going to help with this drug epidemic.   It is not us old folks that are abusing drugs.   

As Flo on Alice used to say   They can kiss  my grits    lololol

[BalletBabe]

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@Carmie wrote:

@BalletBabe  An elderly family member that I take care of told me yesterday that she received a call from Aetna because she did not refill her RX on time and they were concerned that she was skipping taking her meds,

She said she did not not have enough money to refill, so she went without for a week.  The caller told her that it is possible that she could receive help paying for her meds and someone would call her to discuss this.

The person who might be able to help called while we were at the pharmacy picking up seven different RX meds and left a message saying she would call back.

It seems like there is some concern over RX meds and the elderly..

hopefully, for the best.  

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@Carmie  My Pharmasist said that people are filling them and taking them home and flushing them.   My Dr. called my RX in without my permission.  I told him I needed to do some research on it, because I knew I had taken it before and had issues.  I told the Pharmacist to put it back, I refuse to take it as I had bad reactions from it before.  I said if I cannot sleep , I will get more cleaning done.  LOL

[BalletBabe]

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@chrystaltree wrote:

We this was coming.  The addicts and those who use drugs recreationally won't be affected by these rules.  They'll still get whatever drugs they want, any time they want them.  But those of us who have pain will have jump through hoops to get our legally prescribed medication.  We'll have drag our selves, pain and all, to the doctor to get prescriptions and then to the pharmacy to get our 7 day script filled.  Physicians cannot call in some scripts for medications, we have to have the script and show our id's.  So, we'll pay for other peopl's problems.  It's what happens in this country.  "Feel good" regulations that do nothing to address the problem.  They exist just to make people feel like something is being done.  

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You are right on with your statement.  Really sad.  

[BalletBabe]

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@Allegheny wrote:

My thought regarding my insurance company (Aetna) requiring pre-auth for pain meds is how long this pre-auth process will take.  IE., there is a medical or dental emergency visit whereby the physician feels it is appropriate to prescribe.  So the physician has to go thru process of pre-auth?  I don't think the medical profession is going to be too happy about this.

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@Allegheny  Trust me they are not but I do think in a case of emergency they would be allowed to prescribe something.  I feel bad my Pharmacist was telling me that she is so frustrated with all of this.  She said she calls people and tells them to pick up their RX and they are flipping out on her.   

[BalletBabe]

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@Carmie wrote:

@Allegheny  I am sure your ohysician"s office is well aware of the need for preauthorization and they probably have experience in complying with this process.

Almost every insurance company and pharmacy is aware of the new laws and regulations.  They have experience in getting authorization in a timely manner.

In today's crazy world of RX drugs, preauthorization is commonplace.

My daughter was diagnosed with MS about 13 years ago.  MS drugs are very expensive.  She has to go through the Preauthorization procedure once a year for her drugs.

This preauthorization might be new to you, but it isn't new at all.

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My Dr. nor Pharacist knew about this for what I was taking.  I had the rx, but it would not go through.  It took several phone calls before I found out what was going on.  I am glad Medicare took all that money out of my paychecks in order to give me all this grief and crappy insurance.

[Allegheny]

I hope I didn't confuse people with my original post.  I should have clarified that I was referring only to policy change of my insurance company Aetna.  I was curious whether other insurers were making changes to their requirements.

[Lindsays Grandma]

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@BalletBabe wrote:

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@Allegheny wrote:

We just received notification from our insurer of new guidelines for medication preauthorization.  They have added various pain medication which will need preauthorization.  My husband is reviewing the new directive and it may also include some other controlled substances such as medication for anxiety.  With the drug problems in this country I certainly understand.

Just curious if anyone else has gotten notice from their insurer regarding this issue?

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I didn't get notice but I went to fill an RX I have been taking for 17 years.   I think that is horrible.  Wait till someone is out then you tell them that they cannot have anymore?    

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When and if the day comes I am told my prescriptions for my pain meds can't be filled I will go straight to rehab because I will go into serious withdrawal.  I fully understand the concern about people overdosing but while the DEA is committed to shutting down pain clinics or lowering everyone's prescriptions they are not considering the patients who desperately need relief from their severe pain. 

I was told by my pharmacist four months ago that my insurance company approved my medication for the year, which by the way I have been taking for over ten years.  Can't wait to see what happens in 2018.  Insurance Companies and Pharmacies should not have a say in who can and cannot have their pain medication...I saw that in FL where a pharmacy refused to fill a man's prescription while he was standing there in pain, not right!!!   No wonder people are turning to medical marijuana.

[garmer]

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@Laura14 wrote:

Okay, that is just BS with Tramadol.  I can't believe @Kachina624 and @wvumountiefan are having issues with that.  

Tramadol is Schedule IV which is the lowest controlled substance there is meaning low potential for abuse but it's there so they watch it.  

We're not talking the Schedule II Oxycontin and Vicodin everyone is trying to reign in here because of the high potential for abuse meaning stay on it and severe dependence is definitely gonna happen.  

There is no reason for that drug to be as inconvenient to obtain as the real culprits.  Complete overaction.  

They need to brush up on their drug classifications again or read them for the first time.  There is a big difference between Schedule II and IV.  Learn it, insurers.  

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Tramadol has been changed to a schedule III. They changed it a while back. It works like an opiate as it interacts with the opiod receptors in the brain. It is classified as an opiod.

[BalletBabe]

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@Carmie wrote:

Insurance companies often require preauthorization for expensive drugs.  They might require you to try a lower cost alternative first.

Many states are passing laws for narcotic drugs.  All providers, insurance companies and pharmacies must comply.

They are trying to make it more difficult for illegal use of these drugs to continue, but unfortunally, it's getting more difficult for patients who really need the meds to get them too.

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Well that is not it in my case.  I was taking a generic and I was on BC/BS I paid less then 5.00 for 3 months, guess what when I started on Medicare the drug went to 70.00.  Figure that one out?   I cannot even talk about this anymore it is making me so angry.  This isn't goingto control drugs in any way.  These young people that want drugs will find a way as they always have.  Just sad they have to put us through this.  I feel like my Dr. hands are tied behind his back.   It is just wrong.  

[Financialgrl]

Only read the first two pages and sorry if this has been posted before but, in addition,  I've noticed pharmacies in my area also now have a sign indicating that any prescription presented for opioid pain meds will not be filled until a call is made to the doctor's office verifying it's authenticity.  Also states that the patient is responsible for ensuring that they not wait till the last minute for refills bc there are no exceptions.