Can’t get my refill, new insurance won’t cover

Does your insurer cover Suboxone? Do you have trouble getting insurance to pay? Does your state medicaid program cover Suboxone? Have a beef with your insurer? Vent here!
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Jess1208
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Can’t get my refill, new insurance won’t cover

Post by Jess1208 » Sun Jan 12, 2020 8:57 am

Hey guys. I’m not sure what I’m going to do. I’ve been on 4mg for a few years now and never had this issue before. Well my insurance just switched and they will not cover my meds. (They won’t cover most of my meds, doesn’t matter if it’s generic or not. I’m currently withdrawing from suboxone, antidepressants, migraine preventatives, and other migraine treatments in various forms like injections)

I’m freaking out. It’s already been an entire week And I can’t afford to pay out of pocket. My body is physically dependent on all of these things and they’re all being ripped away from me at the same exact time. I don’t know what I’m gonna do.

I suffer chronic daily pain and am bedridden when I am not forcing myself to go to work. I’m already at risk of losing my job because my migraines are so bad. I cannot deal with this right now. I feel like everything is spinning out of my control.

Jess

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Re: Can’t get my refill, new insurance won’t cover

Post by jennjenn » Mon Jan 13, 2020 6:11 am

Oh no Jess! I hate to hear this!!! I can feel your pain!

How long are we talking about your insurance taking its time and not covering? Or is it not going to cover your medication at all? This kind of thing happens a lot seems like. I know patients that have a copay and because of this they literally cannot stay in treatment and I hate that!

I have not had insurance the entire 8 years I’ve been in this treatment, I pay cash for the clinic bill & my medicine. I just paid $80 for 10 tablets on Friday. It is expensive treatment and I truly don’t understand why it isn’t something that is cheaper since it’s such an important thing. Is there any way you can get a few tablets out at a time from the pharmacy? Most pharmacies don’t mind this, mine doesn’t. There’s times I’ll get 5 out because that’s all I can afford that week. Is that something you can do? Anything is better than withdrawal. If you got 4 or 5 8mg’s out that would last you 10 days.

I sure hope there’s a solution Jess! There has to be, so let’s try to figure this out.
Jennifer

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Re: Can’t get my refill, new insurance won’t cover

Post by Jess1208 » Mon Jan 13, 2020 9:20 am

Thank you for your reply. I love your pic by the way... my sweet bun's name is Thumper. He is the light of my life. I dont know what Id do without him!

The pharmacy said theres nothing they can do theyre waiting to hear back from my doctor and the place I go to has like 5 suboxone doctors (they do inpatient and outpatient) but apparently theyre hard to get ahold of. I know it always gets crazy around the new year with prior auths but Im not sure how much longer I can wait. Im only on 4mgs/day so its not like I had a huge amount in my system I was already feeling like I was having mild withdrawals every single morning on that dose. And with my chronic migraines, my body is SO super sensitive to every single thing and I know my depression and my pain are only going to get worse from here.

Im trying to be positive but its hard. I never thought Id have to deal with something like this. This insurance is supposed to be "much better".... but its already proving to be a nightmare. My clinic is so hard to get ahold of. They see hundreds of patients on MAT and theres only one nurse who handles everyone so I have no idea if or when this will actually get resolved. Don't even know HOW that will happen.

I think Im gonna have to ask if I can go back to generics and end up paying the full out of pocket cost for those but if thats the case then I need to raise my dose because I have always felt VERY unstable whenever I was given generics. Like I was only actually absorbing 25% of my dose each day. Of course any suboxone doctor isn't going to believe that though. And no, suboxone does NOT help with my pain. I wish it did but unfortunately im not one of the lucky ones.. I think having migraines my entire life my body is just worn out and every little sense is heightened and every little thing is magnified to me/my body. Its hard to explain to someone who doesnt feel that way but Im sure someone out there gets it. Its like ALL of my senses are heightened. In the worst possible way. Every little sound or light is like an icepick to my temples

Even if this gets fixed within the next week or so its gonna take months for my body to get back in balance, between my stability and my migraines. Im barely functioning as it is I cannot handle my migraines being any worse

Thanks for listening to me rant. I see others have viewed but youre the only one who took the time to comment so thank you Jenn.

Jess
"Though no one can go back and make a brand new start, Anyone can start from now and make a brand new ending." -Unknown

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Re: Can’t get my refill, new insurance won’t cover

Post by jennjenn » Sat Jan 18, 2020 9:21 pm

Not a lot of ppl posting right now...... come on ppl we need each other and you can remain anonymous so respond to each other because we need it! :)

Jess, my clinic has always been that way too, lots of patients but one nurse and 2 doctors. It gets so incredibly busy that you can be told something and counting on it but totally forgotten as soon as you walk away. That’s why I’m suggesting that you remind them every freaking chance you get! Aggravate the bejeebus out of them if you have to. Seriously, I’ve witnessed it, sometimes that’s the only ppl that get results, the ones that don’t care to keep bringing something up until it’s resolved. They may get annoyed but honestly you’re paying them. They’re providing you a service that you pay for and you’re not asking for anything crazy plus it means your sanity. Just keep on girl, keep on! You’ll get results that way I promise you that. Please don’t hold off, start tomorrow because you’re important and you don’t have to settle just because they are busy. Ok I’ll stop ranting lol but I promise you, I’ve been on both sides now and the ppl that just wait being polite not wanting to bother the employees, they finish last. Not on purpose either, it’s just because you’ve been forgotten under the load of other patient files. Bring your files to the top :) and aggravate!

My bunnies are so sweet. Especially my Gizmo. He sleeps at my feet almost every night. I don’t know what I’d do without him. Glad to have another bunny mom at the forum!

Feel better Jess. I’ll be thinking of you!
Jennifer

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