Out of Sotck

@AmbiePam (44533)
United States
February 10, 2009 1:16pm CST
Two weeks ago I tried to pick up a prescription I take for being bipolar (no, not an anti-depressant). Medicaid pays for the generic, and that is what I always get. The pharmacy was out of the generic because the company who makes it is back ordered. So the doctor had to send a prior authorization to Medicaid so they would pay for the name brand. The pharmacy has not heard anything back. They have faxed them more than once. The hold up is Medicaid. The pills are six dollars each. The entire month's cost for the name brand is over 300 dollars. Right now I'm paying two days a head of time. If Medicaid would push through the prior authorization I could get my money back. If they don't, I'll take the hit for the money, no refunds. It looks like they won't. I can't afford 300 something dollars. The other pharmacies don't have the generic either. Apparently, they all order from the same company. Does anyone know what I can do? I don't have the money to get the rest of them. The company who makes the generic still hasn't sent a new order out because they reportedly still don't have them. If I applied to a place that helps out people with medications, by the time they got to me, I'd already be into next month and the generics would be in stock again. In two days I'll have to buy more. Does anyone know what I can do? Who I can contact? Everything seems to have to take time, but the medication is something I have to have every day. Ideas?
5 people like this
16 responses
@cynthiann (18572)
• Jamaica
10 Feb 09
I am so sorry that you cannot get your medication. As you rightly said, it is something that you need to take daily. I am not a US citizen so I do not know of any organisations that can help you. I do hope that someone will answer you post so that you can be assisted. Take care of yourself. I will pray hard for you to get the medicines B;blessings
3 people like this
• United States
10 Feb 09
I understand completely. Unfortunately, generics have never worked for me. I have to have the brand only. My meds are over well over $6,000 a year...and I have insurance that cost $800 a month..It does not help much. The only other thing you can do is to ask your doctor for samples to hold you until the pharmacy gets the med in. If they say they have no samples on hand, ask what they suggest you do.
2 people like this
@AmbiePam (44533)
• United States
10 Feb 09
My doctor won't give out samples. The clinic where he works (he is a psychiatrist, for bipolars on Medicaid, it has to be treated by a psychiatrist, not a regular doctor) forbids it. I don't know why. I guess it is because of the number of people they treat. I asked the pharamacy what to do, and they said just buy the pills on a two day basis. Which is all well and good, but it is still going to end up costing me over 300 dollars if Medicaid doesn't act. And it is already adding up...
1 person likes this
• United States
10 Feb 09
I would think that if Medicaid asks for the doctors approval and it was agreed upon because of the situation, they are agreeing that they will indeed pay it. Can you send them an email and ask them? I understand what you are going through, I go through this all the time.
1 person likes this
@AmbiePam (44533)
• United States
10 Feb 09
They told me to call directly when I e-mailed, so I called. And they said it just takes time. That even if the generic wasn't available, it might still not be there obligation to pay for it. But I'm going to keep on them.
@pergammano (7756)
• Canada
10 Feb 09
Dearest AmbiePam...I am sure there are a lot of people here that would like to make suggestions to you....but a lot of us, do not know the policies of your MedicAid...or how it is meted! Is it possible, thru your Dr., to have him find one of his other patients that may take the same presciption and he/she contact those persons to see if it possible they share their supply...til new shipment arrives, and have your Dr. have the Pharmacy set aside borrowed amount? All I can think of...sorry, m'dear!
2 people like this
@AmbiePam (44533)
• United States
10 Feb 09
I appreciate your help and concern. No, unfortunately it is illegal for someone to share another's medication. If I knew a family member who had it, I know they would help me illegal or not to share. lol
1 person likes this
@catdla1 (6005)
• United States
10 Feb 09
Hi Ambie Have you tried calling Health for Friends? Given the situation, they should be able to help you.
2 people like this
@AmbiePam (44533)
• United States
10 Feb 09
I need to look them up.
1 person likes this
@winterose (39932)
• Canada
10 Feb 09
see about that company anyway sometimes they might have some in supply, call a free clinic as them if they have any, ask your doctor if he has samples, or your hospital, social worker etc,
2 people like this
@pyewacket (43962)
• United States
11 Feb 09
I don't know if Medicaid works differently within each state but I don't see why you can't get the "brand" name of the medication through Medicaid. Every time a doctor fills and writes out a prescription on that paper it says "Fill generically unless otherwise indicated"--meaning he has to check that box to indicate NOT to fill out generically--the difference in how much it costs usually runs like this. Under our state's "rules" if the prescription is generic than all I have to pay is a mere $1.00...for brand name $3.00---and it seems the standard for just about any medication...uh, I think..LOL. So in some ways it seems up to the doctor to authorize (not just Medicaid) to have the brand name of the prescription. Of course, it just might be different with me as I not only have Medicaid but HIP--do you have any other health plan with Medicaid? They that is Medicaid sought of forced it down on us to choose another health provider plan whether we wanted it or not and not just be represented by Medicaid...sheesh.
1 person likes this
@AmbiePam (44533)
• United States
11 Feb 09
Medicaid is it for me. The funny thing is this, they say they will only cover three brand name medications. Now if the generic is available, they want me to have all generic. But I can only have three brand names a month, that is it. But here is the kicker...this month I only have one brand name! So why is it a problem to get this one?! That would just make two.
1 person likes this
@pyewacket (43962)
• United States
11 Feb 09
PS--did you know that generic brands are usually inferior to the brand names anyway? I wrote a discussion about this and an article..Rendoxy..the company is from India,..think that's the name is the one major generic brand of medications made for just about everything and they even showed cross contamination of medications as they would all be manufactured all at once....
1 person likes this
@pyewacket (43962)
• United States
11 Feb 09
You and I must have been writing at the same time...LOL. No idea about that--since you said this is the only brand name you have this month you should be able to get it
1 person likes this
@camomom (7537)
• United States
11 Feb 09
You should contact Medicaid and explain the situation. Don't depend on the pharmacy to take care of it. Another thing you can do is contact your doctor and explain the situation and see if they can change your medication. Good luck.
1 person likes this
@AmbiePam (44533)
• United States
11 Feb 09
The doctor is actually the one who is supposed to contact medicaid. And they can't change my medication. It's bipolar medication, and you have to go off of it slowly. And then you have to slowly get on another one. The thing is, in a month they will have the generic. It's just this one month. But I'm checking every resource I can think of.
@camomom (7537)
• United States
12 Feb 09
Sorry to hear that. I hope everything works out for you. Good luck.
1 person likes this
@hdjohnson (2981)
• United States
11 Feb 09
AmbiePam: That is an unfornunate situation there. Have you tried ordering your prescriptions online direct from a manufacturer? That is about all the advice I can give. I know people who have used online services before and they seem to enjoy it. I'm not sure about whether or not your prescription is there or even available. But you better believe I'm talk to our father about this, he knows how to grant you the favor or finances you need to take care of your situation in a timely manner. Also, I'll ask him to grant you the wisdom, during this time.
1 person likes this
@AmbiePam (44533)
• United States
11 Feb 09
He would pay for it, I know he would. In fact he knows about it and wants to pay. The thing is, he and my mom went to the dentist yesterday. My mom is going to have to have some work that will cost 600 dollars. My dad also has to have a tooth pulled a crown put on (their old dentist was apparently not only expensive, but incompetent). But we are praying about it together. And I know something will work out.
1 person likes this
@hdjohnson (2981)
• United States
11 Feb 09
I was referring to the father you and I both have.
1 person likes this
@nanajanet (4437)
• United States
11 Feb 09
Try writing directly to the manufacturer (or calling). Sometimes they will assist you. Also, find out if the dr. has any samples. That is all the advice I can give. Sorry for your problems.
1 person likes this
@AmbiePam (44533)
• United States
11 Feb 09
I appreciate your advice. Any advice is always welcome.
@makingpots (11928)
• United States
11 Feb 09
That's what I was going to suggest, let your doctor's office know the situation. The often have samples and they know better than most what a pain all the insurance red tape can be.
1 person likes this
@gabs8513 (48803)
• United Kingdom
10 Feb 09
Wow that is awful again they are playing with Peoples Life I just do not get it I really hope that you can get this mess sorted You could phone Medicaid themselves and see what the hold up is
1 person likes this
@AmbiePam (44533)
• United States
10 Feb 09
They just told me there was nothing they could do. That it was just the way the system worked. By the way, sorry I wrote sotck, instead of stock!
1 person likes this
@gabs8513 (48803)
• United Kingdom
10 Feb 09
That is terrible they always blame it on the System someone has to work the System for goodness sake Don't worry about the Spelling I knew what you meant
1 person likes this
@makingpots (11928)
• United States
11 Feb 09
Oh what a pain, AmbiePam. Unfortunately, situations like this often require hours on the phone talking to a bunch of people who all believe the problem is with someone else. As I mentioned above, I'm make sure your doctor's office knows the situation and perhaps can supply you with samples to get through this time.
1 person likes this
@AmbiePam (44533)
• United States
11 Feb 09
Nope, no samples. I found that out the hard way.
• United States
11 Feb 09
You said Medicaid, so I am assuming that you live on the East Coast or the Midwest. I live in California, so we do have Medicare and most people have health insurance if they do not have Medicare. I have only have to pay $5 for my medications because I have Kaiser. I would not know who to call if you have Medicaid. We have CVS pharmacy and Wal*Mart and usually they give people their medications for less. They will fill the prescription if you have it.
1 person likes this
@AmbiePam (44533)
• United States
11 Feb 09
Walmart doesn't have the generic either. Apparently they get that generic from the same company. I never thought of that. I didn't think most pharmacies got their generics from the same company as the others.
@GardenGerty (87552)
• Marion, Kansas
11 Feb 09
I might call my senator. Also, my doctor. Sometimes they have samples that they can give out at their discretion. I would apply anyway for the help if you know of an agency that will help you. How about the Salvation Army?
@AmbiePam (44533)
• United States
11 Feb 09
This is the first place I've ever been to that doesn't give samples. My theory is because it is a clinic. Because I'm on Medicaid, I'm seen by a psychiatrist every couple of months for about ten minutes, just to see if the medication is working okay. I found out when I first came that they won't give out samples. Of course I asked why, and they said it was because too many people requested them. Didn't seem like a good reason to me, but like I said, it was the first time I've ever been seen at a clinic instead of a "regular" office.
@lilybug (21182)
• United States
11 Feb 09
That is horrible. I don't know who else you could contact to get it. There is a company called Express Scripts. It is a mail order company. My sister used to do computer work for them. Maybe they still have some of it.
1 person likes this
@Opal26 (17694)
• United States
11 Feb 09
Hey ambie! That is really crazy! Isn't there something that your doctor can do to help you? Believe me I know how it is dealing with Medicaid since I have the same problem! There has to be something that you can do! Have you spoken with your doctor and explained this to him so that maybe he can make some calls? I wish I knew what to tell you. You could try getting them in Canada, but I don't know how you go about doing that at the last minute. It doesn't make sense that all the pharmacies would be out of stock on the same medication. I will send you an email to talk to you in private.
1 person likes this
• United States
11 Feb 09
Do you have a Medicaid office near you? I would be going to the Medicaid office and talking to them pronto if I could. I am wondering if I may ask what it is that you take? What is the name of it? I am also wondering it may be a long shot. But I am wondering if there is any way that after this whole bout if the doctor could possibly add you an extra script. So that you could get an extra bottle when they come in stock in case any of these incidents were to happen again. And all the pharmacy's are out. Have you tried like the next town over to see if any of their pharmacy's have them in stock? Is there any way that you could transfer your scripts to an online pharmacy that had them in stock, if any of them do???? I do not have a clue. I am just typing what is popping in my head.
• United States
11 Feb 09
Okay I am back. I know that you cannot quit your medication cold turkey so I was thinking that maybe you could 2morrow instead of taking a whole one only take 3/4 of one and do this for a few days and then take 1/2 of one and once you get your script filled you can slowly up your pill dosage again until you are on your 1 pill a day again. If you could do this you could cut your cost a little bit. I know it would not be a lot but it would help. And once you get your medicine back if you slowly went back to full dosing you would have a few extra pills just in case this were to happen again.
1 person likes this