Wednesday, May 30, 2012

Tuesday, August 04, 2009 MomofGavin asks

Q: My insurance will not cover my sons adhad medication(concerta) Are there any other options for me!

My son has tried different meds and so far concerta is the only one that works. Well our insurance will only cover it for 3 months out of his whole entire life!! Now if that isnt the dumbest thing i have heard. Is there any way to get the insurance company to cover it or is there any way around this?? different meds???

 

RachelYell

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Answers (2)
Eileen Bailey, Health Guide
8/ 6/09 10:43am

Rachel

 

You can file an appeal of the insurance company's decision. Contact your state's department of insurance and ask how you would go about filing an appeal. There should also be information on how to do this on the form you received telling you the insurance company has denied paying for the medication.

 

Many people that file appeals win, so don't be discouraged.

 

Let me know how it works out.

 

Eileen

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2/23/10 2:30pm

I'm another adult with ADD who is having problems paying for my concerta. One of my biggest problems is that without the meds, it's nearly impossible to deal with the challenges involved with trying to get those same meds. It's a never ending cycle! If I could handle the process I wouldn't need the concerta, but I can't get the concerta without dealing with things that are too difficult without it. It's like telling someone with a broken leg that they must walk to the hospital to get their leg healed. I'm so tired.

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Eileen Bailey, Health Guide
2/23/10 2:36pm

You can try Partnership for Prescription Assistance

 

Major pharmaceutical companies work together to help make sure all people have access to medications. You can read more about how to receive medications through this program: Free or Low Cost Medications

 

Eileen

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8/ 4/09 4:05pm

Well I am right there with ya.  I am 34 and have ADD/ADHD and have insureance but it doesn't have mental health on it..stupid..then what am I working for to pay this crap insurance?  I had to stop taking my 54m of Concerta because I can't afford it..my car payment is on the line to begin with. So now I'm dealing with anxity attacks and I have no mental health so now what?  RRGH!! Let's write to Mr.Big Shot and tell him how it is...I'm gonna send hom copies of my bills and tell him to deal with it!!  Foot in mouth

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8/ 5/09 10:44am

Im behind you 100%!! We live in america and cant get our medication we need. I was floored when i was told they wouldnt cover his meds. I guess we need to go live in canada and get free healthcare or be poor with 25 kids to get help fromthe state!!!!

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By MomofGavin— Last Modified: 12/24/10, First Published: 08/04/09