Getting abx covered

[nicklemama]

Does it never end? DS was prescribed biaxin by Dr T last Sat, for 10 days, 2 refills. I called in the refill this morning and went to pick it up this afternoon. Our insurance company has denied it, saying something like its too soon and doesn't meet some kind of guidelines. DS is supposed to be taking this for 30 days straight. We have enought to last until his Tues pm dose.

 

The pharmacist told me she was a new pharmacist and not really experienced in getting the insurance to cover it. She's going to keep working on it today and if not successful, hand it off to the experienced pharmacist tomorrow to try and get this filled.

 

Initially, I thought I'd just pay for it myself. How much could a 10 day supply of generic biaxin be? $86!!!!!!!

 

If you have experience or insight on how to get this filled w/ my prescription insurance, I'm all ears. In the past week, I've paid out of pocket for a neuropsychological evaluation and a consult w/ Dr T. I will get my DS the biaxin but I'd sure prefer my insurance to pay for it, since I do pay for my insurance. Thanks.

 

Cindy

[philamom]

You might've tried to pick it up too early. I know with my plan, I would have to wait until the 9th day to pick up. If that's not the problem--try seeing if Dr. T will give you a new script for 30 days with no refills.

[peglem]

Yeah, I'm thinking he should have given you a 30 day supply. I think refills are flagged if you do them less than a month apart.

[Megs_Mom]

We have to have ONE prescription per month - most plans will not let you do 10 day, 3x a month. Tell your doctor this for the next one. If he calls in a NEW prescription, that should work - it did for us. Also he could call in a new prescription for 30 days, with a slightly different dose, and that will definitely work.

[nicklemama]

Thank you all for the information. The pharmacist just called me and tomorrow's pharmacist is going to try and get this done or call Dr T and get a new prescription. Not only do they not want to refill the prescription because of the timing thing but they are saying the dosage is too high for a 6yo child. Its 250mg 2x a day.

 

Cindy

[airial95]

We have the same issue as philamom, if we try to refill to soon, it's denied.