Insurance denying "early refill" for Vacation

Anything about buprenorphine that doesn't fit somewhere above, fit it here!
Post Reply
User avatar
Super Poster
Super Poster
Posts: 166
Joined: Fri Feb 26, 2016 10:20 am
Location: USA

Insurance denying "early refill" for Vacation

Post by Jess1208 » Tue Aug 13, 2019 10:14 am

Hi guys,
As some of you may know, Ive been on subxone & in recovery for almost 5 years (anniversary coming up in 2 weeks!)

Ive never ran into this problem but am dealing with it now, I had to go to group for my monthly refill one week earlier than normal, since I am going on a family trip to Disney and would be out of town on my normal scheduled time (we go every 4-weeks for our scripts).

I went to get my script filled at the pharmacy right after group, and after about an hour of waiting, the pharmacist told me that my insurance is denying the "early refill" request. They told me I will have to pay out of pocket, or use one of those discount cards, since I wont be able to fill my script using my insurance card. The pharmacist also said I could buy 2-weeks supply out of pocket so I would have enough to last until I get back home, but I'm not doing that... I have Anthem BCBS through my employer.

It is now Tuesday morning. We leave Friday night. I DO have enough leftover films (from dropping a whole 20mgs since I first started). I let my suboxone nurse know that, so she is aware I have extras. I also let the Pharmacy know, they are usually very professional and I know I have nothing to hide so Im wondering if my suboxone nurse will just tell me to use my extras and she can write me a normal 4-week script that I will have to fill when I get back home.

This situation is reason enough to prove why I felt I needed to be prepared for whatever may happen in the future in regards to my medication. I have dropped my dose A LOT since I first started.. Ive been on 4mg/day for awhile now, and when I was on higher doses, I would just forget to take my second film, or my afternoon dose of half-a-film... So over time I just ended up with extras here and there. And I am so glad I did.

Im going to try calling my insurance today and request an override but I won't be surprised if they keep saying no. I had been scared to speak up about having extras before but I think the honesty is REALLY going to help me with this whole thing.. Has anyone else had to deal with this?? An early refill for vacation being denied? What did you do?

When I was on Methadone maintenance around 8 years ago and went on a similar family trip to Disney, I had it all set up that I was going to "guest dose" at a clinic about an hour drive away from Disney (we were all staying on disney property). Everything was completely fucked up and apparently they never got my paperwork, and we arrived on a friday.. so by the time I got to the clinic in Florida, MY clinic was already closed for the day (the weekend hrs for my "home clinic" were VERY limited, only open 2 hours on weekends, SUPER early in the morning). That following monday, my counselor (who was supposed to make sure the paperwork was all approved and said this would be an EASY process) was "not in" that day. Needless to say, that was an absolute nightmare. I was withdrawing badly for around 5 full days before I actually got to take my methadone.. the majority of the trip. I was on an extremely low dose too since I was in the middle of my taper, so the WDs were even worse. Each morning on "vacation", I spent around 3-4 hours every morning TRYING to get my dose, driving out there was over a 2-hr round trip, waiting around at the clinic, for them to tell me each day that they weren't allowed to give it to me.

The horror stories of not having your meds for whatever reason DO happen. It happened to me. I wanted to make sure something like that would NEVER happen again if I could do something about it. So I don't feel guilty or "bad" about having a little extra at home. You never know when something like this might happen. Apparently its going to happen to me again. This trip, I will not be withdrawing.

I really don't even want to go on this trip, my family is toxic for me to be around, everyone besides my two kid nephews.. but I am trying to be positive. (which is a new thing for me)
"Though no one can go back and make a brand new start, Anyone can start from now and make a brand new ending." -Unknown

User avatar
Posts: 940
Joined: Wed Dec 28, 2011 6:47 am
Location: Southeastern US (Alabama)

Re: Insurance denying "early refill" for Vacation

Post by jonathanm1978 » Tue Aug 13, 2019 11:55 am

I had this happen to me when I was leaving out for vacation to stay in a beach house for a week...around the end of may. I sent my doctor a text on Thursday explaining that I had just realized my appointment was on the following Tuesday, and we would be leaving out sunday for our 1-week trip. She dropped a 1-month script in the mail that very same evening, which I received on Saturday and got filled right away..then just made up when I got back home.
Adam Wayne P.
DOB: July 1, 1985
October 8, 2013

RIP little brother. Gone, but not forgotten.

Post Reply