New Ins, what do I do???

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Regular Member

Date Joined Apr 2008
Total Posts : 58
   Posted 12/12/2008 1:27 PM (GMT -6)   
My workplace switched insurance companies effective 12/01/08.  We have coverage, but cannot file anything because of course they don't have us in the computer yet.....Fine for most people.  I went at the end of November and filled ALL my scripts early so I wouldn't have a prolblem, save one, my Oxycontin because it was too early to fill and the old insurance rejected it.  Well, I had enough till yesterday, and now am out and my poor pharmacist can't help.  He told me if it was any of my other meds, he would fill them and wait till next week to file them, but because of the new insurance and the fact that it is my Oxycontin, he just can't.  I understand his position, but what about me?  Do any of you have any suggestions about what I can do?

Veteran Member

Date Joined Jul 2008
Total Posts : 2317
   Posted 12/12/2008 2:08 PM (GMT -6)   
Methadone is pretty inexpensive. I know it's not a great solution, but maybe you could use that until your new insurance kicks in. So sorry for your predicament. Hopefully someone else will have a better solution.

When will your new insurance start covering scripts?

Pete trips again!
Veteran Member

Date Joined Nov 2006
Total Posts : 1899
   Posted 12/12/2008 2:20 PM (GMT -6)   
Tell your Human Resourses director if you have one exactly whats going on and let him/her earn their pay by getting your insurance company on the phone to tell them whats going on! Thats total BS! What if your life depended on the meds you can't get? If you don't have a Human resources dept. at work, then call the insurance people your self or have your doc or pharmacist call them. Remember, the skeaky wheel gets the grease! Yell and scream if you have to, I would!
Your friend,
55 years old, Surgury, Radical Prostatectomy 8/20/03, PSA 6.6, Gleason 3 + 3 = 6, Adenocarcinoma extent (moderate) Stage & Margin:T2NOMX, No Metastases, Organ Confined, bone scan: Neg. 3 1/2 years of depression after surgery prior to Hypogonadizm DX, Testosterone Theropy (Testim Gel)since 12/06 but switched to a higher dose of (Androgel) 6/08. Fighting to stay upbeat daily. I am's what I am's and that's all that I am's! (Popeye)  55 and still alive!!! Feel free to pray for me, I can use all the help I can get!!!

Regular Member

Date Joined Apr 2008
Total Posts : 58
   Posted 12/12/2008 3:19 PM (GMT -6)   
My HR lady is working on it today, partly because my son was at the ER with possible appendicitus yesterday and the WOULDN'T touch his without a precertification. They ar supposed to be rushing mine thru to cover all of that, but prescriptions are another thing I guess. I have a call into the DR, just waiting for him to call me back....after the excitement yesterday with my kiddo, and no oxcycontin since yesterday morning, I am already really starting to hurt, its going to be a long weekend!

Veteran Member

Date Joined Nov 2007
Total Posts : 6795
   Posted 12/12/2008 3:35 PM (GMT -6)   
Yes, keep your HR person on top of it, but one thing you might try is getting all your ID and group numbers from your HR person (even if you don't have a card yet) and the prescription benefit may have different numbers. Of course you're busy with your son right now, but as far as the insurance goes that may help move things along. Insurance companies also have different computer systems and sometimes you're in one but not yet in another part of the system. But this is your HR person's responsibility and again follow Pete's advice. At least see if they might be willing to give you part of a month's supply until everything is worked out, although with pain meds it's not so easy.

I just had to switch pharmacies yesterday because of my insurance and already this morning got a call they didn't have one of my anti-convulsant meds in and couldn't get it from any of their 3 suppliers. And this is a hospital pharmacy! So I called my old CVS and sure enough they have some in stock and thankfully this is the cheapest of all my meds and the private pay is actually less than the co-pay, so I'll have to go to them for this one drug. Can't wait to see what happens when I pick up the rest on Monday and see what a mess they've made of it. And my percocet doesn't come until the end of the month. I did like you and waited until 11/30 to get that filled and my doctor's office was even nice enough to give me a few extra so I could go into the first week of Jan. rather than all the holidays.

They just don't know how they mess up our lives when they play these games like we're pawns on a chess board. I guess to them we are.


Veteran Member

Date Joined Jul 2007
Total Posts : 554
   Posted 12/12/2008 3:37 PM (GMT -6)   
they should cover you even though you do not have a card yet. call the insurance co & get the info you need to fill the script. explain to them you are dependant on this medication. perhaps they could even fax a card to you. either way they can get on the phone & tell the pharmacist the info you need. don't let them bully you. here is another idea.... explain to your dr whats going on & get a week supply of oxy. its expensive out of pocket- i know i don't have insurance & pay about $600 a month alone for this med. but maybe get enough to get you by until the insurance gets their stuff together. better hop on it either way with the weekend coming up. let us know how it goes, i have gone through withdrawls before because i couldn't afford my script & its unreal pain. i don't know how anyone could do it without a drs help. good luck! walgreens has a card for people without insurance, so maybe they can help while you are waiting. it helps some, don't expect anything huge. also, walmart has meds fairly cheap. hang in there, we are all here rooting for ya!
RX's: Oxycontin 80 MG 2x's daily; Dilaudid 8 MG 4xs daily; Zanaflex 4mg 3x's daily; Restoril 15mg 1x; Soma 3x's daily; Lyrica 100 MG 3x's daily (pain & fibro.); Phenergan 25 MG (as needed); Amitriptyline 25 MG 1x (chronic pain); Cymbalta 60mg 2x's daily (pain from fibro); Metoclopram (as needed) & Senokot (as needed).
"The most critical choice you'll ever make is the one you make about what you're going to do with this. The past is over. The future hasn't happened yet. The only time is now."
- Dr. Phil

Regular Member

Date Joined Apr 2008
Total Posts : 58
   Posted 12/12/2008 4:14 PM (GMT -6) guys had some ideas that I hadn't thought of....I will let you know!

Veteran Member

Date Joined May 2005
Total Posts : 4219
   Posted 12/14/2008 7:08 PM (GMT -6)   
If your son does need surgery remind the ER under EMTALA they have a duty to stablilize a patient in an emergency situation regardless of the patients ability to pay. So if your kiddo needs his appendix out they better get a snipping and not give you a hassle over insurance. The only way this would not apply to your hospital is if it was private and did not accept Medicaid or Medicare patients.

Has far as your script - call the new company hit zero until you speak to a human and tell them you need your ID number, group number etc. because you need to use your coverage before your card arrives.

The other option is to put it all on a credit card and file a reimbursement with the new insurance company as soon as you get their info.
27 Year old married female law student (last year!!). Diagnosed w/ CD 4 years ago, IBS for over 10 years before that, which was probably the CD. I am sort of lactose intollerant too but can handle anything cultured and do well w/ lactose pills and lactaid. For crohns I am currently on Pentasa 4 pills/4x day and hysociamine prn. I also have bad acid reflux and have been on PPI's since age 13. I have been through prilosec, prevacid, and nexium. Currently I am on Protonix in the morning and Zantac at night. I also take a birth control pill to allow some fun in my life.

Regular Member

Date Joined Apr 2008
Total Posts : 58
   Posted 12/15/2008 9:25 AM (GMT -6)   
I ended up just paying for it, the pharmacy is going to run it on my insurance as soon as I get my card, and reimburse me. It was a horrible experience that I NEVER wish to go thru again!

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