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Tuesday, November, 24, 2009
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Doctor speaks out about insurance limiting triptan Migraine medications

Teri Robert
Teri Robert
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Teri Robert is Writing a SharePost
Author of "Living Well with Migraine Disease and Headaches"

Patient advocate and writer Teri Robert's career moved in this...

Teri Robert

Tuesday, June 26, 2007
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If you use triptans (Imitrex, Maxalt, Zomig, Amerge, Relpax, Axert, Frova) and have insurance, you may very well have run into insurance coverage limits on how many doses are covered per month. For quite some time, the average seemed to be nine doses. Now, many insurance companies are lowering th...
  1. triptan limitation
    Tana Jansen
    Tuesday, June 26, 2007 at 04:50 PM

    Who should know better than the dr. and the patient what medications are needed. When meds are limited the patient "saves" meds for the really bad ones and consequently gets more really bad ones. The migraines get worse instead of better.


    It will end up costing Insurance compies more in the long run.

    Reply
  2. Dr. L'Europa
    dragondrool
    Wednesday, June 27, 2007 at 12:23 AM

    This sounds like a very wise, compassionate doctor. It's probably a good thing he's not in the room with me, or he'd have found the stuffing knocked right out of him from a sudden droolie dragon smoosh. I'm liking this guy. :)

    Reply
  3. please everyone respond
    Ian G
    Wednesday, June 27, 2007 at 03:09 AM
    Please -please - take the time to respond so that there is a huge response - there is a link in the article - we need to respond so those idiots at United Healthcare and all insurance companies for that matter know - that they have to stop rationing our medication. The more responses - the more the insurance companies will know we can't be taken for granted! It will only take a moment of your time
    Reply
  4. limits on migraine meds
    betsyb
    Tuesday, July 03, 2007 at 07:23 PM
    I'm a little slow, but I sent Dr. L'Europa a note saying that I support any efforts to stop insurance companies from practicing this ridiculous policy.
    I urge everyone who can to respond to him - it doesn't take long and it's the least we can do as good citizen/consumers. There are enough migraineurs in this country to pursuade others on these issues!
    Thank you, Teri, for posting this article.
    BetsyB
    Reply
    re: limits on migraine meds
    Teri Robert
    Tuesday, July 03, 2007 at 11:06 PM
    You're welcome, Betsy. This is a huge issue for Migraineurs.

    Teri
    Reply
  5. Untitled Comment
    tam
    Friday, April 17, 2009 at 11:57 AM

    It's actually 4 tabs per 7 days.  So you can get 16 pills per month.  You will just have to pay 4 co-pays.  But a few of the triptans are on 1st tier which makes them only $10 per script.  Your doctor just has to write the script out correctly.  If you have mail order it's 16 pills for one co-pay. 

    Reply
    re: Untitled Comment
    Teri Robert
    Friday, April 17, 2009 at 12:37 PM

    Tam,

     

    It depends on the insurance company. Mine is 8 tablets per month, 24 tablets or 90 days. Period. It doens't matter how the doctor writes it, and my insurance company will pay for ONE prescription of 8 per month when I fill at a local pharmacy or ONE prescription for 24 for a 90-day period. No matter how my doctor writes the prescription, they will cover only one prescription for 30 days or 90 days, depending on whether I fill it locally or by mail order.

     

    Teri

    Reply
    re: re: Untitled Comment
    Tamara
    Friday, April 17, 2009 at 04:08 PM

    Sorry - just for United Healthcare

    Reply
    re: re: re: Untitled Comment
    Teri Robert
    Friday, April 17, 2009 at 04:30 PM

    Thanks for the clarification, Tamara!

     

    I have a bad feeling that it's going to change soon anyway. Now that Imitrex generic is becoming pretty widely available, I have a sinking feeling that insurance companies are going to stop covering other triptans unless we get them approved in advance.

     

    Just my opinion.

     

    Teri

    Reply
  6. UHC is horrible
    Sufferer
    Monday, May 18, 2009 at 10:31 AM

    Imitrex is now generic--but did that fix this problem for UHC consumers? No. I am on birth control and Imitrex (actually any triptans work for me), but I can't get the medication I need because my employer chooses to work with this pitiful excuse for an insurance company.

     

    I applaud any doctors who speak out againt this. However, the problem still remains. I wish this country would just cure me or kill me. Having a migraine for four days and having to go to work with one is horrible.

    Reply
  7. So glad I found this article
    SusieB
    Tuesday, November 17, 2009 at 04:47 PM

    I just found out that Federal Employee Program Blue Cross, Blue Shield allows 36 Relpax pills, and I evidently passed that up, using 12 for two months in a row. My doctor now has to agree to provide proof I need more than that amount, and the lady I spoke with who called to tell me that today said she didn't know if my doctor would allow more. I told her I take them so I don't get to the constant-vomiting-I-have-to-now-go-to-the-ER stage. To not have them means I'm at risk for that happening. (I realize I was graphic with her.) I am going to write my insurance company and include this article. I will also send a copy to my neurologist.

    Reply
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