First no Auvi-Q and now I can only get 1 box of EpiPens?!

[2boyz4me]

First off - our prescription coverage no longer covers Auvi-Q, which is a shame because Holden had no problems carrying it around with him. So much more convenient for a boy.

Well today, when I went to get his inhalers and EpiPens filled for school, I was able to get 2 inhalers (1 for school and 1 for home) but the EpiPens got bounced back as I could only get 1 box of 2. Well, we all know this won't work. So I had to call insurance and verify that was the case (express scripts) and then had to talk to the appeals department and have the doctor fax over a letter of medical necessity in order to have them dispense 2 boxes! I'll have to go back next week to get them while the process goes through (darn good thing I didn't wait until the last minute!!!).

I even asked how often I could get the prescription filled ... once every 30 days! It'd always been unlimited - I could get 2 sets of 2 EpiPens whenever I needed them (I would usually get 4 full sets at the start of every year - we've never needed them FWIW).

SO frustrating! We're good for now and hopefully we'll continue to never need them but geez!

anyone else run into this?

[hezzier]

I ran into the epi pen problem before with our pharmacy.  Next year have your doctor write a one time only script for 2 boxes (we used to do 3 boxes) of epi pens with no refills.  Then get a second script 1 box of epis that can be refilled if necessary.  It was a way to get around the 1 refill every 30 days.

[CMdeux]

Our prescription coverage won't allow for the work-around-- it's per PATIENT, every 30 days.  Period.  I asked.

  Instead, we have gotten scripts for ME that are refillable (usually I don't carry as many sets as we want DD to have)-- if we needed to, we'd also get DH a set.  And no, it's not fraudulent, since he has a nut allergy and I have a SFA and anaphylaxis Hx-- it's just that we actually swap them around so that DD has (minimum) 2 sets, mixed lots.

I refill mine a lot less often than we get hers refilled, though, if that makes any sense.

I asked what the heck you're supposed to do if you, say.... USE a set within a couple of weeks of picking them up??  No answer on taht one.       So we make sure that we ALWAYS have one more set (minimum) than we think we actually need to have around.  {SIGH}

This is a STOOOOOPID policy.   

[Macabre]

DS is going into the 11th grade. Most of the last 12 years we've started getting the epis for school two months before school was out so we have enough to place around school. His personal ones we get at a different time if we need to.

DS' insurance doesn't cover the Auvi, but mine does. He and I both have scripts for the Auvi. Guess what we do.

[my3guys]

My old insurance policy was like that 2boyz, and I appealed and got nowhere.  I fought them pretty hard too and they wouldn't budge.  If I wanted to pay out of pocket, I could get them but this was all my insurance would do. End of story. So I got into the habit of purchasing epipens for school starting in June.

My new insurance gave me no problems this summer, and it was a relief.  It's such a ridiculous policy!!!

[2boyz4me]

We will see what happens. I reiterated both with both the insurance company AND the doctor's office that we've NEVER **KNOCK ON WOOD** had to use EpiPens, NEVER EVER but that we always want to be more than prepared of course. I'll figure something out if the appeal doesn't go through, but I hope it does

[Mookie86]

Insurance companies can override how often you're allowed to get more medication if it's deemed an emergency.  If you need to use the epipen less than 30 days after filling the prescription, I'm guessing that'd be deemed an emergency because obviously it's dangerous not to have a replacement!

What a pain that insurance companies make things more expensive and more difficult.