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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 3 of 3. This is the beginning of the thread.
Posted by alohashirt on December 28, 2003, at 21:18:59
I have been using Strattera for three
months (50mg daily) with moderate effects.
Have just begun this + extended release ritalin
and am seeing better effects - more focus, less daytime sleepyness.Oxford have denied covereage for the Strattera scrip on grounds of "not medically necessary" Their letter stated that Strattera wasn't indicated for use in combination with a stimulant.
Has anyone else experienced this?
Can I direct a pharamacist to only try to bill oxford for the more expensive drug?
Should I opt to try just a ritalin-like drug?
Posted by sb417 on December 28, 2003, at 22:55:14
In reply to Oxford won't cover straterra + stimulant for ADHD, posted by alohashirt on December 28, 2003, at 21:18:59
Get your doctor to appeal Oxford's decision. Be persistent. Keep fighting for it. Don't take "no" for an answer. My doctor has had to fight for me on a number of occasions. It's time-consuming and exasperating, but, unfortunately, that's the way medicine is practiced now.
Posted by Bill LL on December 29, 2003, at 10:42:31
In reply to Oxford won't cover straterra + stimulant for ADHD, posted by alohashirt on December 28, 2003, at 21:18:59
I agree with sb417. A good starting point might be to call Oxford's customer service. Ask to speak to a supervisor. Ask the supervisor what it would take for Oxford to consider the combo "medically necessary". For example, maybe they would accept a note from your doctor.
If the supervisor is not helpful, go up to the next level supervisor.
Obviously, if the same doctor prescribes 2 drugs together, then he/she considers it "medically necessary". Oxford's only motivation is to save money.
This is the end of the thread.
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