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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by jdk1081 on June 25, 2006, at 16:38:56
My Phy increased my Ambien from 10mg to 20mg at bedtime. Been on Ambiem for >10yr. Now all of a sudden my insurance compy is refusing to fill my scrip citing it exceeds FDA approval limits. I've been taking 10mg Ambien + 2mg Xanax just to get to sleep (I have cronic back pain and can't stay asleep thru the night) and still wake up in about 4hrs. Sometimes I also take 7.5 ydrocodone when pain is high! Doc doesn't want me mixing the three drugs.
The 20mg Ambien alone is working just fine now: however since my Ins company will not fill more than 10mg/dose I need data to support 20mg regiment other than my medical records, which only support my pain condition. Any one have any suggestions where i can obtain good data to support 20mg regiment?
Ins has requested I write a ltr requesting reconsideration with supporting data. Sound strange I should be writing such a ltr. but at this point I am will to do anything.
JDK1081
Posted by MidnightBlue on June 25, 2006, at 17:31:07
In reply to Ambien 20mg, posted by jdk1081 on June 25, 2006, at 16:38:56
Good luck! My insurance won't let me have 10 mg a day for more than a couple of months! I, too have been on Ambien for more than 10 years. If I stop it for a week or so it starts working better again.
MB
Posted by cecilia on June 25, 2006, at 18:22:39
In reply to Re: Ambien 20mg » jdk1081, posted by MidnightBlue on June 25, 2006, at 17:31:07
My insurance company won't cover Ambien at all. I have to pay $3.11 for each 10 mg. tablet. Cecilia
Posted by Phillipa on June 25, 2006, at 22:02:58
In reply to Re: Ambien 20mg, posted by cecilia on June 25, 2006, at 18:22:39
I don't understand why won't insurance cover ambien? Love Phillipa
Posted by MidnightBlue on June 26, 2006, at 0:29:18
In reply to Re: Ambien 20mg, posted by Phillipa on June 25, 2006, at 22:02:58
Because it is expensive and people like/need it.
MB
> I don't understand why won't insurance cover ambien? Love Phillipa
Posted by cecilia on June 26, 2006, at 2:09:50
In reply to Re: Ambien 20mg » Phillipa, posted by MidnightBlue on June 26, 2006, at 0:29:18
> Because it is expensive and people like/need it.
>
> MB
>
> Exactly! Cecilia>
> > I don't understand why won't insurance cover ambien? Love Phillipa
>
>
Posted by B2chica on June 26, 2006, at 10:46:08
In reply to Ambien 20mg, posted by jdk1081 on June 25, 2006, at 16:38:56
if your ins paid for 10 and not for 20, is that per/day also?
if not, have Rx made out for double dose at 10mg. that's what i did. i was taking 20mg, but i had 10mg tablets...worked fine for me..hope for you too.
good luck.
b2c.
Posted by jdk1081 on June 26, 2006, at 19:26:30
In reply to Re: Ambien 20mg, posted by B2chica on June 26, 2006, at 10:46:08
> if your ins paid for 10 and not for 20, is that per/day also?
> if not, have Rx made out for double dose at 10mg. that's what i did. i was taking 20mg, but i had 10mg tablets...worked fine for me..hope for you too.
> good luck.
> b2c.
Guess I forgot to mention that my Doc made the scrip out for x2 at bedtime. That's what so confussing. Rx filled my scrip for the above mentioned regiment, but will not give the quantity! This leads me to believe it's all about the money, not my health. You see, I only pay a set amount for mail order rx reguardless of qty. Even CM's CS rep stated the same.I have a scrip Caremark filled with the direction stating take 2 at bedtime, but only gave me 90 tabs. Go figure. 90 day supply x 2/day =180 tabs. Dr wrote 180 but CM only dispensed 90. What a mess!
Posted by Phillipa on June 26, 2006, at 20:47:35
In reply to Re: Ambien 20mg » Phillipa, posted by MidnightBlue on June 26, 2006, at 0:29:18
MB what other meds doesn't insurance cover? There are lots of others that make people feel good and need them. Maybe I'm glad I have no med insurance cause I sure wouldnt want someone telling me what I could have or not have after a doc prescribed it for me. Unfair!!!! Maybe that's a reason so many people use things like alchohol instead? I don't know do you? Love Phillipa
Posted by gardenergirl on June 26, 2006, at 21:50:46
In reply to Re: Ambien 20mg » MidnightBlue, posted by Phillipa on June 26, 2006, at 20:47:35
Posted by MidnightBlue on June 26, 2006, at 22:09:25
In reply to Re: Ambien 20mg » MidnightBlue, posted by Phillipa on June 26, 2006, at 20:47:35
My insurance won't pay for my blood pressure med except in the higher doses. I take 75 Avapro and that costs less than my $50 per month deductable.
Also they would only pay about $9 on a $59 rx for hot flashes. On Ambien I pay $50 per month for 30. But they won't let me have 30 every month. They said that was too much!
There are more.........
MB
Posted by Phillipa on June 26, 2006, at 22:29:58
In reply to Re: Ambien 20mg » Phillipa, posted by MidnightBlue on June 26, 2006, at 22:09:25
Well maybe medicaire doesn't pay for meds but it pays a lot for ER, docs appointments, MRI's. I didn't realize the plans were so bad now. Love Phillipa
Posted by willyee on June 27, 2006, at 11:32:29
In reply to Re: Ambien 20mg » B2chica, posted by jdk1081 on June 26, 2006, at 19:26:30
Medicare part d,the medication plan,that exsists for people with medicare but not MEDICAID,from my understanding does not cover...
Any benzo
And does have policys on certain drugs,Ambien is one,ambien being closly related to benzos im not surprised.
Before part d,medicare had i believe no coverage for meds,unless u had medicaid,so if there are small limits such as these,however in general most drugs will now cost u approx 5 dollers,then i believe its still a great change.
20 mg is a lot of ambien,just ask ur doc for an altrenative med to add,one that is covered,to subsititute for the lowered ambien dose.
Elaval is a good med for sleep and pain,and the list is huge of drugs that can be used off label for sleep.
Posted by Phillipa on June 27, 2006, at 21:19:40
In reply to Re: Ambien 20mg » MidnightBlue, posted by Phillipa on June 26, 2006, at 22:29:58
Willyee Medicaires drug coverage doesn't pay for any psych drugs and now they are saying it's kindda a scam as the cost of the add on insurance is high and I think you only get something like ten percent off. Let me know if I'm wrong as I have Meidcaire. Love phillipa
Posted by willyee on June 27, 2006, at 23:08:18
In reply to Re: Ambien 20mg » Phillipa, posted by Phillipa on June 27, 2006, at 21:19:40
> Willyee Medicaires drug coverage doesn't pay for any psych drugs and now they are saying it's kindda a scam as the cost of the add on insurance is high and I think you only get something like ten percent off. Let me know if I'm wrong as I have Meidcaire. Love phillipa
Wow unless im mistaken that is quite a understatement,medicares prescription plan went int effect in jan,and is quite huge,mainly because it has a lot of bugs needing to be worked out,lot of mistakes etc which is expected when u have so many people going on it at once.
Its called plan D,and offers medicare particpants drug coverage and very much covers psych drugs.
Posted by Phillipa on June 27, 2006, at 23:11:32
In reply to Re: Ambien 20mg, posted by willyee on June 27, 2006, at 23:08:18
Willyee is their a site that lists the drugs I remember when the plan first came out someone posted it didn't cover psych drugs. I stand to be corrected. What would I google? Love Phillipa
Posted by gardenergirl on June 28, 2006, at 13:25:25
In reply to Re: Ambien 20mg » willyee, posted by Phillipa on June 27, 2006, at 23:11:32
There are hundreds, if not thousands of plans one can choose for Medicare Part D. They all vary in what they do and don't cover. It's important when selecting which plan is right for you (for those who qualify for Medicare) to check their formularies to make sure most if not all of their current meds are covered.
Non-medicare prescription drug insurance plans also have formularies of what they will and won't cover. Unfortunately, those who's group health insurance comes from their employer usually don't get to choose, so you can be stuck with what they offer.
gg
Posted by tjeffries on June 30, 2006, at 10:58:35
In reply to Ambien 20mg, posted by jdk1081 on June 25, 2006, at 16:38:56
I take 20 mg. also, and what my insurance does, is make me fill it every two weeks, as they say the cannot give me all the pills at once....therefore they get paid twice a month for my monthly dosage....lol. But that is how my Dr. writes it now. 10 mg., two a nite, for 14 days, and then puts a bunch of refills on it, so I can go back every 14 days.
This is the end of the thread.
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