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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by Phillipa on April 28, 2005, at 21:33:56
Hi fellow Babblers. Maybe you can help with this question. My daughter just told me her husband's insurance company will no longer pay for his ritalin. He has ADD. He is in his 30's. I'm not on any stimulant, and wondered if any of you know why? Thanks, Fondly, Phillipa
Posted by vivi on April 28, 2005, at 21:50:19
In reply to Ritalin, Insurance Won't Co;ver?, posted by Phillipa on April 28, 2005, at 21:33:56
> Hi fellow Babblers. Maybe you can help with this question. My daughter just told me her husband's insurance company will no longer pay for his ritalin. He has ADD. He is in his 30's. I'm not on any stimulant, and wondered if any of you know why? Thanks, Fondly, Phillipa
Thats strange becaue it should since ADD is a diagnosis. I have no problems with my insurance company, just the looks I get from the Pharm Techs. I went from Ritalin 20 mg to Dex 10 mg to Dex 15 mg in about a 2 month period and had no trouble. Hopefully the Doc can call and find out.
Viv
Posted by alohashirt on April 28, 2005, at 23:01:35
In reply to Re: Ritalin, Insurance Won't Co;ver? » Phillipa, posted by vivi on April 28, 2005, at 21:50:19
That sounds weird - ritalin is very cheap. No problems with Oxford, whereas teh expensive Concerta and Strattera needed authorization first.
Posted by Phil on April 29, 2005, at 15:12:00
In reply to Ritalin, Insurance Won't Co;ver?, posted by Phillipa on April 28, 2005, at 21:33:56
His insurance provider may have a drug formulary or a preferred drug list. It should be illegal but as we all know, the drug companies have lots of friends in Washington.
I still don't see why they wouldn't cover Ritalin.
Who knows?~ ~
Phil~
Posted by stargazer on April 30, 2005, at 23:42:12
In reply to Ritalin, Insurance Won't Co;ver?, posted by Phillipa on April 28, 2005, at 21:33:56
Did they pay for it in the beginning as you said "will no longer cover". If so, they would have to explain why they are no longer covering it.
Alot of insurors reject stimulants coverage for ADD for anyone older than 18 based on the belief that only children have ADD. Since we know that's not true, getting the stimulant med covered depends on a letter from the MD once a year, in my case, to explain what the diagnosis is and why the stimulant is being prescribed.
Stupid but nevertheless a roadblock to getting the drug covered. It should be covered once you validate the reason why it is being rejected. Call for an explanation and then have the doc write a letter.
GOOD LUCK.
This is the end of the thread.
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