Is Anyone Experiencing Supply Limit On Triptans With Their Insurance Company?

Question

Asked by politichickdc

Is Anyone Experiencing Supply Limit On Triptans With Their Insurance Company?

Is anyone experiencing supply limit on triptans with their insurance company? United Healthcare now limits the supply for all triptans to only 4 per month, no matter the drug (brand or generic). How can this be best medical practice? Sometimes i need more than one pill for a migraine and certain months depending on the weather and stress (my triggers) I may have more or less than 4 migraines. Is anyone else encountering the same problem? Is this a recent change? My former health plan (Aetna) provided 9 pills per month. HELP!

Answer

politichickdc,

Oh, yes, and it's all about $$ and the deals the insurance companies make with the various pharmaceutical companies to get good prices on all of the meds the companies make.

Let me give you an example - I was using Axert, and was limited to 24 tablets for 90 days. Then I got a letter from my insurance company informing me that the were no longer going to pay for Axert without my doctor jumping through hoops, but they would pay for Maxalt or Relpax. So, my doctor wrote me a prescription for 36 Maxalt-MLT tablets for a 90-day supply. The insurance company covered it - 12 tablets more than they had covered when I was taking Axert. To add to all of this, when I went back and looked at what the insurance company had paid for my Axert prescription compared to what they're now paying for my Maxalt prescription, they're paing $6 per tablet more for Maxalt. It was explained to me that it has to do with which companies will give them the best prices overall on all of their products, not individual products.

Insurance companies don't seem to care what our doctors feel is the best treatment for us. It's all about the $$.

Teri

Answered by Teri Robert