Posted 6/28/2020 6:04 PM (GMT -6)
In some ways, that is pretty complex.
So, they won't let you have the two prescriptions for the pristiq, one for 100mg and a second for 50mg (since what you need is 150mg), because that's 2 prescriptions?
What, they have a limit on prescriptions? It's like a guillotine. Even if your doctor says you need it?
I know one of the rules used to be, if the psychiatrist recommended something, the insurance company doctor could use his judgement, and say that was too much. But if the psychiatrist really, really wanted that, the insurance company would grant it.
It's not like that now?
Well, just like you said further in your post, "...I know I need more but my insurance wont pay for more pristiq, so we have been trying to add another med but I haven't been able to tolerate side effects."
If "we have been trying to add another med," to go with the first script of 100mg prestiq, that's 2 scripts right there, or 1 for prestiq and another for a 2nd med. It's the same as 1 script for 100mg of pristiq, and a 2nd script for 50mg of prestiq, or, 2 scripts.
So, why can't they give you 2 scrpits of prestiq (one for 100mg and one for 50mg), if they are willing to give you the 2 scripts of 100mg of prestiq and a 2nd script of "another med."
Don't make me come up there.
Can your psychiatrist explain this to them?