How do you all get around this?

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Dowa
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Date Joined Sep 2008
Total Posts : 1120
   Posted 12/22/2008 4:32 PM (GMT -6)   
The only antibiotic my body can seem to tolerate is Azithromycin. Occasionally I think about trying it. I have Blue Cross/Blue Shield and they will only fill a prescription for 3 tablets as that is how it is normally prescribed. (They go by the book and are a pain in the butt) How do you all get around that non-sense and get it for months at a time? Thanks  D

seeingstars
Regular Member


Date Joined Apr 2008
Total Posts : 266
   Posted 12/22/2008 6:55 PM (GMT -6)   
I hope someone has a way to do that for you. But if you can't find a way I'd look into the overseas route. You could buy all the zith you wanted if you can afford it.

Dowa
Veteran Member


Date Joined Sep 2008
Total Posts : 1120
   Posted 12/22/2008 7:01 PM (GMT -6)   
Thanks SS. Yes, I got a web site one day here to get it overseas but I have the insurance so I feel like I should be able to use it, just looking for a way. Thanks D

seeingstars
Regular Member


Date Joined Apr 2008
Total Posts : 266
   Posted 12/22/2008 7:05 PM (GMT -6)   
Or even better, if we lived in the same area I'd give you my unused bottle. I know it would be illegal probably but that was one drug that was a waste of my $10 copay. Glad it works for you.

Dowa
Veteran Member


Date Joined Sep 2008
Total Posts : 1120
   Posted 12/22/2008 9:43 PM (GMT -6)   
You mentioned your co-pay which means you used insurance. They didn't give you a hard time filling it for more than the 3-pack? Dont know why I am having that problem other than what the pharmacist said. (about the 3 day dose) Thanks D

seeingstars
Regular Member


Date Joined Apr 2008
Total Posts : 266
   Posted 12/22/2008 9:47 PM (GMT -6)   
Nope, no problem at all. I was getting 60 250mg pills for at least 3 months

Razzle
Veteran Member


Date Joined Aug 2007
Total Posts : 4399
   Posted 12/22/2008 11:15 PM (GMT -6)   
It has to do with the diagnosis code used when the prescription is submitted to insurance by the pharmacy. It also has to do with the details of your prescription insurance coverage plan. If I were you, I'd discuss this with your pharmacist - they know more about the ins & outs of how to get insurance co's to pay for prescriptions. If this insurance is through an employer, sometimes going to your HR dept. and talking with your benefits coordinator may be helpful also.

Good luck,
-Razzle
Chronic Lyme Disease, Gluten & Sulfite Sensitivity, Many Food/Inhalant/Medication Allergies & Intolerances, Asthma, Gut issues (dysmotility, non-specific inflammation), UCTD ("Secondary Lupus-Like Syndrome"), Osteoporosis, Anemia, Lymphopenia, intermittant Pancytopenia, chronic malabsorption/malnutrition, etc.; G Tube; Currently TPN-dependent.
Meds:  Zofran, Pulmicort, Heparin (to flush PICC line).


Dowa
Veteran Member


Date Joined Sep 2008
Total Posts : 1120
   Posted 12/22/2008 11:48 PM (GMT -6)   
Thank you. I think he was avoiding a Lyme diagnosis because of things we had heard about the way insurance feels about it. He is not LLMD, its all new to him. I had read that with insurance its best not to say the LD words because they think 30 days of treatment should cure it. NOT true??   D

yaniv_naced
Regular Member


Date Joined Sep 2007
Total Posts : 134
   Posted 12/23/2008 1:09 AM (GMT -6)   
What about generic zithromax?
Or Clarithromycin (generic name for Biaxin)?

seeingstars
Regular Member


Date Joined Apr 2008
Total Posts : 266
   Posted 12/23/2008 9:46 AM (GMT -6)   
Dowa-

you ? if diagnosed with lyme ins. may think 30 days and done. It is possible in some parts of the U.S. I know I have bc/bs and my doc always marks chronic lyme on my sheets. I have yet to have a problem getting meds. It's been 1 1/2. Orals and 2 picc lines.

There have been others on here who don't live close to me that have had problems with insurance cutting off drug payments. So sad.

Razzle has mentioned a smart thing. Call your insurance and ask where they stand on lyme treatment. If you think you can trust them. This whole illness has mad me paranoid of anyone involved in my getting better. (Doctors, Insurance, Pharmacies)

*Bella*
Veteran Member


Date Joined Jan 2007
Total Posts : 1254
   Posted 12/23/2008 9:56 AM (GMT -6)   
Hi Dowa,

I was unable to get my insurance to pay for Zithromax (they later dropped me). I had to pay $500 per month for brand Zithromax, because I am not able to take generic drugs. I know they claim to be the same, but I have always been very sensitive to medication, and with Lyme that just got worse.

The side effects from the Zith were bad enough for me to stop, as I was damaging my stomach and getting horrible chest pain every time I took it. Way too much pain to just be considered a herx (although obviously herxes are painful, I knew this was different).

Dowa
Veteran Member


Date Joined Sep 2008
Total Posts : 1120
   Posted 12/23/2008 1:18 PM (GMT -6)   
Azithromycin IS the generic for Zithromax. I didnt call BC/BS  because I DIDN'T trust them, really. I think most insurance will try to get out of paying if they can, seems that way anyway to me. I am glad some of you get to use your BC/BS, so far they are not paying for treatment here. Thanks everyone for your replies... I'll see what I can do..D

skigal
Regular Member


Date Joined Mar 2008
Total Posts : 79
   Posted 12/23/2008 6:27 PM (GMT -6)   
Dowa - which BC/BS do you have? Anthem, Carefirst?  Your insur. co. should have a website where you can locate your pharmacy med benefits.  My insurance also only allows 3 - 500 mg Azith pills, so I just get the 600 mg one for either 30 or 34 days w/refill.

Post Edited (skigal) : 12/23/2008 5:33:51 PM (GMT-7)


Dowa
Veteran Member


Date Joined Sep 2008
Total Posts : 1120
   Posted 12/23/2008 6:34 PM (GMT -6)   
Skigal: I have Anthem, you probably do as well if they said the same to you about he 500 mg. I didnt know they made a 600 mg, makes no sense does it, that they would approve the 600mg and not the 500. Silly...

skigal
Regular Member


Date Joined Mar 2008
Total Posts : 79
   Posted 12/23/2008 7:02 PM (GMT -6)   
Dowa, I have Carefirst Bluechoice (HMO) & yes it is silly.  I was having problems getting the 250 mg pill, so I had the doc write a rx for 600 mg (30 days)  & I just cut them in 1/2.

Dowa
Veteran Member


Date Joined Sep 2008
Total Posts : 1120
   Posted 12/23/2008 8:58 PM (GMT -6)   
Makes no sense to me, but good to know theres a way around it. Thanks!! D
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