OK so Brandon was on the patch and we all loved it. It took a bit too long to get into his system but once it was in his system it then took forever to get out of his system. This means he was regulated more than any other ADHD meds he has taken. This patch stayed in his system and more like 24 hrs than the instant attention span and then the lost scattered brain. This was definately more regulated.
Anyway, as we venture into the meds and really like the results our insurance policy was adjusted with my husband's firm to make some minor adjustments and yes one of them was the patch. It was no longer available but we coul purchase it for $250. a month. Apparently there are other medicines that we can use that have the "same effect" as the patch per our insurance. So we tried a few and YEP everything got worse. He would take the meds and come crashing down when it was out of his system and he would be bouncing off the walls until he took it. I didn't realize how well the patch had regulated his body.
Then we went to Concerta 10 mg and got to the dose of 30mg. We sent a letter to our insurance requesting a review of the patch for Brandon and to let us continue with it but we were denied. The insurance said we had not tried all the other "less expensive" meds and not tried the "Name Brand Drug" instead of generics so when we went with the Brand Name and got the prescription filled with the Doctors prescription we found out the insurance had to "pre approve" us. WHAT you just said we had to use these meds in our request for the patch that we were denied through you and now we have to have your "pre approve?" So as noted above, we start with 10 mg and realized we need the 30mg and since I was approved we order the new dose only to find out we are denied again. What? we need to have the new dose "pre appoved" again by the insurance. Just being approved for one type does not include all doses, and yes that does make sense but when you are in the throws of this it is frustrating. You call to get a prescription filled only to find out you are denied and have to find out why and who to contact.
So I took the next measue and went to the state to get approval on our patch. I guess once your insurance denies it and you have tried everything you can go to the state to overturn. anyone who works with insurance or has child that needs various meds must know all this. Anyway so I sent it to the state with letters from the psychologist, therapist and the dr working with him on neuro. I got the reversal YEAH. Now my insurance is suppose to pay for the patch. I got the letter from the local source and from my insurance.
I love all the paperwork that you get from the insurance company letting you know they recieved your paperwork and then when it goes your way you get the letter letting you know they received the same letter and then another letter stating that they will be covering the meds... and yes they did say the patch and they did write the EXACT AMOUNT we have ordered in the past so if he grows and we need to go up a dose... I get to start all over.
They make more work in the insurance industry for themselves than their customers do. No wonder health care costs are up. So exhausting. But we are back on the patch and things are looking good. Now when our approval runs out next October I must learn what I need to do.
UGH
Anyway, as we venture into the meds and really like the results our insurance policy was adjusted with my husband's firm to make some minor adjustments and yes one of them was the patch. It was no longer available but we coul purchase it for $250. a month. Apparently there are other medicines that we can use that have the "same effect" as the patch per our insurance. So we tried a few and YEP everything got worse. He would take the meds and come crashing down when it was out of his system and he would be bouncing off the walls until he took it. I didn't realize how well the patch had regulated his body.
Then we went to Concerta 10 mg and got to the dose of 30mg. We sent a letter to our insurance requesting a review of the patch for Brandon and to let us continue with it but we were denied. The insurance said we had not tried all the other "less expensive" meds and not tried the "Name Brand Drug" instead of generics so when we went with the Brand Name and got the prescription filled with the Doctors prescription we found out the insurance had to "pre approve" us. WHAT you just said we had to use these meds in our request for the patch that we were denied through you and now we have to have your "pre approve?" So as noted above, we start with 10 mg and realized we need the 30mg and since I was approved we order the new dose only to find out we are denied again. What? we need to have the new dose "pre appoved" again by the insurance. Just being approved for one type does not include all doses, and yes that does make sense but when you are in the throws of this it is frustrating. You call to get a prescription filled only to find out you are denied and have to find out why and who to contact.
So I took the next measue and went to the state to get approval on our patch. I guess once your insurance denies it and you have tried everything you can go to the state to overturn. anyone who works with insurance or has child that needs various meds must know all this. Anyway so I sent it to the state with letters from the psychologist, therapist and the dr working with him on neuro. I got the reversal YEAH. Now my insurance is suppose to pay for the patch. I got the letter from the local source and from my insurance.
I love all the paperwork that you get from the insurance company letting you know they recieved your paperwork and then when it goes your way you get the letter letting you know they received the same letter and then another letter stating that they will be covering the meds... and yes they did say the patch and they did write the EXACT AMOUNT we have ordered in the past so if he grows and we need to go up a dose... I get to start all over.
They make more work in the insurance industry for themselves than their customers do. No wonder health care costs are up. So exhausting. But we are back on the patch and things are looking good. Now when our approval runs out next October I must learn what I need to do.
UGH
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