Denied for prescription and unsure what to do

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I had severe ADHD. Since I switched to HBCBS my psychiatrist is out of plan and haven’t been able to get medication. unbeknownst to me I realized I could go to my PCP and see if they can prescribe me my medicine.

Backstory: ive always had a fear of choking on pills however I was able to manage for years. Another story for another day, but I’m unable to swallow pills at this point due to throat issues.

Basically there’s chewable ADHD medication called Quilichew. Dr prescribed it and tried to fill it but insurance wouldn’t authorize it because it wasn’t covered of course.

Went and called my insurance and asked what chewable ADHD medication is covered and they told me Methylphenidate Hydrochloride (generic version/chemical name of Ritalin) is covered in chewable form. I was previously taking generic form of Ritalin so no changes in the actual composition of the medication.

I call my doctor, they write the Rx, I pick it up and go to fill it at my pharmacy and the pharmacist tells me there’s no such thing as generic quilichew. I explained my dr. Wrote me the script and said there was such thing and also insurance told me it was available.

Pharmacist called national drug hotline and turns out there’s no such thing, only Quilichew. I asked how much it would be without insurance and with my Good Rx card and it came out to $400 for 30 day supply.

I cannot function at this point without my medication and there’s no way I can swallow the pill form. It’s unable to be crushed up either so trying to get this prescription is my only option.

Can someone please help me? I feel like I’m in healthcare hell and know other people experience similar situations so hopefully someone can offer me advice or a solution?

submitted by /u/SociologyResearch1
[link] [comments]
I had severe ADHD. Since I switched to HBCBS my psychiatrist is out of plan and haven’t been able to get medication. unbeknownst to me I realized I could go to my PCP and see if they can prescribe me my medicine. Backstory: ive always had a fear of choking on pills however I was able to manage for years. Another story for another day, but I’m unable to swallow pills at this point due to throat issues. Basically there’s chewable ADHD medication called Quilichew. Dr prescribed it and tried to fill it but insurance wouldn’t authorize it because it wasn’t covered of course. Went and called my insurance and asked what chewable ADHD medication is covered and they told me Methylphenidate Hydrochloride (generic version/chemical name of Ritalin) is covered in chewable form. I was previously taking generic form of Ritalin so no changes in the actual composition of the medication. I call my doctor, they write the Rx, I pick it up and go to fill it at my pharmacy and the pharmacist tells me there’s no such thing as generic quilichew. I explained my dr. Wrote me the script and said there was such thing and also insurance told me it was available. Pharmacist called national drug hotline and turns out there’s no such thing, only Quilichew. I asked how much it would be without insurance and with my Good Rx card and it came out to $400 for 30 day supply. I cannot function at this point without my medication and there’s no way I can swallow the pill form. It’s unable to be crushed up either so trying to get this prescription is my only option. Can someone please help me? I feel like I’m in healthcare hell and know other people experience similar situations so hopefully someone can offer me advice or a solution?
submitted by /u/SociologyResearch1 [link] [comments]Read Morer/HealthInsurance

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