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Stimulants Question for people with insurance who have been PRESCRIBED adhd medication

feebleit

feebleit

Greenlighter
Joined
Jan 15, 2016
Messages
15
I'll make this quick.

I have a question for those of you who are over 18 and have been prescribed expensive stimulants as an adult. If you have medicaid/medicare I'd especially like to hear from you.

So I have medicaid and I have recently been prescribed vyvanse for adult ADHD. Vyvanse is an expensive brand name drug so it makes sense why an insurance company wouldn't want to pay for it. I'm over 18 so I need "Prior Authorization" because vyvanse is a stimulant, and I have been waiting almost 2 weeks. My question is... What is the longest you've had to wait for prior authorization to go through for any medication? Does it take longer for medicaid??.... I've been waiting 11 days
 
My Doc sent one in on Thursday and it was ok'd on Tuesday, mine was for Oxymorphone.
 
btw feebleit, get some info from your Doc, has it been requested yet? Call your insurer and ask them if they have received the PA yet and go from there, it should only take 3-4 working days, it can be requested via email. I have requested 3 PA's and none of them took more than 4 working days. Good luck
 
It can take forever..... Once I waited a month constantly getting denied for bs reasons (why not use fentanyl patches instead of OP oxycotin as it will be more effective and safer!) Only to get it approved in like a day or two when I called to get it cleared up...

Definitely call your insurance and ask what you can do to expedite the process as the medication is necessary and affects your quality of life to not have it.
 
Hi Feebleit, I saw your other thread about ritalin but couldn't answer because it has been closed ( it's been years since the last time I logged in here and it seems rules have changed )
If the methylphenidate is hard on you, you may want to try modafinil. I don't know where you are but here in Mx it's an otc medication, you do not need a prescription to get it. In my personal experience it significantly improved my concentration and helped me stay awake during the day and sleep well at nights and it has no risks of dependency. I saw you were looking for amph based stimulants, there is one which is intended for weight loss called phentermine, for me it is the safest amph based stimulant out there but it is good for about one week as the body starts building tolerance so I do not recommend doing it on a daily basis as this one does have high dependency risks.
You do need a prescription for phentermine but I don't think it is hard to get, maybe with a nutritian?

Hope it helped.
 
From one day to the end of the universe is the answer. I am a pharmacist and on 11/29 we started the process for an authorization which was just approved 2/29. And this was commercial insurance, Medicaid, depending on your state, could have just as easily let your auth slip through the cracks as them actually working on it. Call your pharmacy and make sure they contacted your doctor and/or Medicaid. Then call your doctor and make sure they are doing what they need. And after that, you need to advocate for yourself and get someone from Medicaid who knows what the hell they are doing and push them. Contact your case worker to do the same. Good luck, as I know how frustrating it is.
 
The answer is to constantly call the insurance company and doctors office every single day. Put pressure on them. This worked for me with opiates and private insurance. If I recall correctly it only took 2 or 3 days. I don't know about medicaid though, that might be a little different.
 
Kittycat5 said:
From one day to the end of the universe is the answer. I am a pharmacist and on 11/29 we started the process for an authorization which was just approved 2/29. And this was commercial insurance, Medicaid, depending on your state, could have just as easily let your auth slip through the cracks as them actually working on it. Call your pharmacy and make sure they contacted your doctor and/or Medicaid. Then call your doctor and make sure they are doing what they need. And after that, you need to advocate for yourself and get someone from Medicaid who knows what the hell they are doing and push them. Contact your case worker to do the same. Good luck, as I know how frustrating it is.
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Man those are terrible turnarounds times. Hell. I'd be up someone's ass after a day or so. I actually used to have to deal with this when I was on OxyContin and was prescribed 6 pills a day (he hadn't moved me up to the next higher mg per pill yet??). Apparently BCBS only allows 120 or 150 a month without prior authorization. Well, when I'd go to get my meds filled, it was because I was OUT! I stayed in front of the pharmacist for a number of hours while calling the insurance company and insisting on talking to a supervisor and explaining the pickle I was in. All in all it took about 2-3 hours to clear up but I was pissed. After reading your post it seems like I was incredibly lucky to get matters taken care of when I did. Wow, did I say how much I hate dealing with insurance companies!!
 
I agree with mankind, call everyday. I recently had a problem with this shit and ended up having to pay out of pocket. Im on Medicare and have Humana and the meds im on are cool but if they need pa it can be a bitch. Im on Adderall and havent had any problems. I pay 22$ for 30 20mg tablets. Vvance is expensive. Just keep on everybody and bug um to death and you should get results. Good luck!!
 
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