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Insurance not covering brand name

Thu, 01/07/2016 - 10:34

Hi everyone,

I have gone ten years seizure free thanks to Lamictal and Keppra. The insurance I'm currently on made me pay full price for these meds until we hit our deductible of $3500 and then would allow me to pay a $30 copay For the rest of the coverage year.  With how crazy expensive Lamictal and Keppra are, needless to say I hit the deductible by March. Unfortunately, my insurance will change in February and the plans we are looking at no longer cover either drug before or after hitting the deductible. I think there is a process where your doctor can call in and require you to get the brand name. But with many insurance companies you have to fork over a lot more now than a mere copay or they wait for an "event" to occur before allowing you to go back on the brand name. I live in Georgia and we are currently looking at Blue Cross/Blue Shield and Humana. I might be forced to switch to generic if my doctor's appeal to the insurance company isn't successful or the cost is simply too much. I'm terrified of my seizures starting again especially since I have three young children. Has anyone had any success with staying on the brand name drugs, and if so, what insurance company are you with?

Comments

Have you looked into

Submitted by margiefox118@live.com on Thu, 2016-02-04 - 11:10
Have you looked into government programs? If your Dr. can verify your epilepsy diagnosis you could get help from state or federal programs

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