Does anyone have Medco insurance for their prescriptions? My work just shifted to this insurance and they will not fill the prescription for my migraine medicine. They are forcing me to us the generic brand of Imitrix, which does not work, when I need Maxalt. I am so frustrated. I had a three day migraine and took the generic form. It did nothing. My husband finally went to the pharmacy and paid $100 bucks for three, yes, that is 3! pills. Obviously I cannot afford this, especially when I can get up to 7-8 migraines in one month! This drug is like a miracle for me and allows me to function, as in go to work and not call in sick, but they will not cover it. My doctor tried her best, but they won't change their decision. Because my migraines are hormonally triggered, she is suggesting the I go on BCP or even get an IUD to try and lessen their severity...but I am 45 and am not really interested in taking hormones!!! This just seems crazy to me. I am otherwise healthy and have double insurance because my employer requires that both my husband and I pay for it through our benefits package (we both work for the same college) but I cannot get the one medication I need. I am so frustrated. Does anyone have any success story with this company? TIA
Thanks so much ladies. I will be talking to HR and also looking in to buying my meds in Canada. I will also be working with my union to deal with this as I am sure that many other folks I work with are having similar problems. You moms are great. I just knew there would be help out there!
I have not had any problem w/ Medco. There is supposed to be a form that your doctor can fill out requesting a waiver for your Rx to be filled and covered. It is not an easy task but should be able to be done. Talk to someone in your benefits office.
Yes, and this happened to us with my sons meds. I called and they let me speak to a pharmacist. I told them we needed the brand as it would be traumatic for my son (TRUE!) to change meds. He was so fearful that he would not work properly. The pharmacist approved it and it was covered.
So, I suggest you call and ask to speak to the pharmacist. Tell them you are so upset as you know the imitrix will not work and know the maxalt will.
I hope it works for you!!! I'm sending positive vibes your way for success!
You might consider contacting the insurance regulating agency in your state.
I worked for a company that used Medco and the policy then was that you could get a brand-name medication if there was a generic available, but you would pay the brand-name co-pay AND the difference in actual cost between the generic and brand-name.
However, in this situation, it seems like they don't have a generic of the medication you need, so it might be a different issue. Do they fill it through their mail-order system? Check online to see if they cover it that way at all.
Try going through your benefits department at your work. The insurance companies want to keep their clients (the business who contract with them) happy. If they get in touch with them they might have more bargaining power than an individual or doctor.
Never loved Medco, they were always changing what was a "non-preferred" medication. What is your physician actually writing on the prescription?? Maxalt is not Imitrix, same family (Triptan) but not the same medication. If the prescription is for a brand name they can switch to the generic formula but can't switch medications. You can always check with the manufacturer as suggested but I really think you are going to get hosed with Medco. I had them for years and my migraine medication was $240/month with them because of how they changed the classification. No success story here, I ran around and around with them when it was changed. Good thing I was able to predict this with my flexible spending account. Good luck!
You might try contacting the manufacturer to see if they have an assistance program in place to help you afford it. My medication has a $100/mo copay under my insurance, but the drug company covers all but $5 of it.
www.northwestpharmacy.com . They are a high-quality Canadian pharmacy. I have had good luck with them. I take Singulair, which is $100 for 14 pills in the US. I get 100 pills for the same amount from them. They are generic but I don't notice a difference. Why don't you check them out and see if they have the the drug you need in the non-generic version? Good luck!
Has your doctor's office tried to submit a priour authorization? That is what we do for medications that are not preferred under a particular insurance.
Hope this helps!
I am a Benefits Manager and we use Medco. This is called step therapy where you are required to use a less expensive medicine first before they will approve the higher costing drug. Are you sure your dr contacted Medco for a pre-authorization? Did you get a letter stating why your doctor's request was denied? Call Medco and find out. Your doctor should be able to get it approved based upon medical necessity and the fact that you tried the lower cost drug and it didn't work. Good luck!
