Have you ever had your insurance company impose limits on your Migraine medications, or refuse to cover them at all? Many of us have. Is it legal for insurance companies to countermand our doctors' prescriptions? And what can we do about it?

In the summer of 2007, my insurance company suddenly came up with a new policy: after three years of problem-free coverage, they announced that the new "fill limit" for Imitrex was four tablets per month. I was having an average of three Migraines a month. However, some months I had more. Some Migraines take two triptan doses to abort; some come back after aborting for a number of hours. The number of Migraines I was having at that time was a low for me. A few years previously, before I started using abortive medications, I had been having 12 to 16 Migraines per month. I used my Imitrex, as prescribed, at the first sign of a Migraine, and that was one of the reasons I was doing so much better.

What's more, the Imitrex came in a nine-tablet blister pack. In order to receive four tablets, I had to find a pharmacy willing to split the blister pack. I called eight pharmacies; no one would do it. I had my doctor call in a statement of medical necessity. Response: "Sorry you can only have four per month; the average person only needs four per month." In order to get any Imitrex at all, I had to pay out of pocket for the remaining five tablets in the pack. My prescription (which had cost me a $50 co-pay) cost me $185 - a $50 co-pay on four tablets, then $135 for the remaining four tablets.

Sound familiar? Read more about these issues in Migraine Medication Coverage Limited by Insurance Companies.

© Megan Oltman, 2009.