Insurance. Bleh. I have a love/hate relationship with insurance. I love insurance because there is no way we could afford all of the girl's equipment and medication and testing without it. For that, insurance is my best friend. It always seems to be something I am fighting, though, and I get so sick of being on the phone with insurance, trying to figure things out. This week's fun is Madi's seizure medication.
Madi started running low on her keppra and I just had a weird feeling it might take longer than normal, so I called it in a day early. She was on generic Keppra for years until she started getting belly issues and rashes. At that point, which was about 6 months ago, we switched to brand-name Keppra. Everything has been fine, until this week. Suddenly secondary insurance wouldn't pick up their share, and our co-pay from primary insurance is a little over $600 for the month's supply. The pharmacy called our insurance companies, numerous times, trying to figure out the issue (in fact they spent well over an hour on the phone with our insurances, and I sure appreciate their dedication! I, myself, have spent multiple hours on this as well. Yawn!). First they said they needed pre-authorization, so the pharmacy and I called the neurologist office and they sent it in. Then they said it needed the pre-authorization to go to primary first. Again, pharmacist office and I called the doctor's office and they sent that off. It still got denied, so then they wanted to know why she was on brand name, which we clarified. Then they wanted to know why the dosage was changed (which wasn't until this weekend, after they initially denied it anyhow), which of course was because she's still having seizures and had the ambulance ride and ER trip this weekend. What is making it even more stressful though is that now the pharmacy has given us two emergency refills, and said they can't give us any more (though I plan to beg and plead anyway). At that point, I don't know what to do other than pay the $600 co-pay, because there is no way I can skip dosages. This medication is way too important.
We had to follow up with our neurologist because of the dosage change they gave us in the ER, as well as Madi's recent seizures, but when I called Monday to make the appointment, they said he didn't have any openings until the end of May. We needed to get in faster so they told me to leave a message with the nurse. Thankfully, though, before the nurse even called me back the secretary called and asked if I could come in Wednesday (today) as they had a cancellation. I was so happy to get in quickly! This afternoon we headed down to the neurologist and discussed Madi's recent seizure (which we now think was caused by the heat of being outside so long for the horse show, even though she was drinking a lot of water). I also told him about the medication problems I was having so he called the pharmacy while we were sitting there to try and get everything resolved. He wasn't able to make headway so he promised to get his office manager on it and help figure it all out. He also wrote us a prescription for Keppra pills (generic, but they will have no fillers to bother her), because if Madi can swallow those, our problems would be solved. I tried to get her to take them tonight, though, and she couldn't. The other issue is she has to take 3 in the morning and 3 at night. She has a crazy high gag reflex and it makes it hard for her. So far she hasn't been able to even swallow one. Luckily I still have some of the liquid Keppra left, so I was able to give her that. I'll try again tomorrow morning with the pills and hopefully that will work.
At about 4:00 this evening I got a call from our neurolgist's office saying they think they got it all figured out and we should have our medication within 24-72 hours. I am REALLY praying that is the case and I am also really praying for the 24 hours so that we don't run out of the liquid keppra. I would really appreciate everyone joining me in prayer on this!
For now I am off to bed.... I'm exhausted!! Thank you for joining us in prayer. Let's pray tomorrow is the day we get her medication!
Madi started running low on her keppra and I just had a weird feeling it might take longer than normal, so I called it in a day early. She was on generic Keppra for years until she started getting belly issues and rashes. At that point, which was about 6 months ago, we switched to brand-name Keppra. Everything has been fine, until this week. Suddenly secondary insurance wouldn't pick up their share, and our co-pay from primary insurance is a little over $600 for the month's supply. The pharmacy called our insurance companies, numerous times, trying to figure out the issue (in fact they spent well over an hour on the phone with our insurances, and I sure appreciate their dedication! I, myself, have spent multiple hours on this as well. Yawn!). First they said they needed pre-authorization, so the pharmacy and I called the neurologist office and they sent it in. Then they said it needed the pre-authorization to go to primary first. Again, pharmacist office and I called the doctor's office and they sent that off. It still got denied, so then they wanted to know why she was on brand name, which we clarified. Then they wanted to know why the dosage was changed (which wasn't until this weekend, after they initially denied it anyhow), which of course was because she's still having seizures and had the ambulance ride and ER trip this weekend. What is making it even more stressful though is that now the pharmacy has given us two emergency refills, and said they can't give us any more (though I plan to beg and plead anyway). At that point, I don't know what to do other than pay the $600 co-pay, because there is no way I can skip dosages. This medication is way too important.
We had to follow up with our neurologist because of the dosage change they gave us in the ER, as well as Madi's recent seizures, but when I called Monday to make the appointment, they said he didn't have any openings until the end of May. We needed to get in faster so they told me to leave a message with the nurse. Thankfully, though, before the nurse even called me back the secretary called and asked if I could come in Wednesday (today) as they had a cancellation. I was so happy to get in quickly! This afternoon we headed down to the neurologist and discussed Madi's recent seizure (which we now think was caused by the heat of being outside so long for the horse show, even though she was drinking a lot of water). I also told him about the medication problems I was having so he called the pharmacy while we were sitting there to try and get everything resolved. He wasn't able to make headway so he promised to get his office manager on it and help figure it all out. He also wrote us a prescription for Keppra pills (generic, but they will have no fillers to bother her), because if Madi can swallow those, our problems would be solved. I tried to get her to take them tonight, though, and she couldn't. The other issue is she has to take 3 in the morning and 3 at night. She has a crazy high gag reflex and it makes it hard for her. So far she hasn't been able to even swallow one. Luckily I still have some of the liquid Keppra left, so I was able to give her that. I'll try again tomorrow morning with the pills and hopefully that will work.
At about 4:00 this evening I got a call from our neurolgist's office saying they think they got it all figured out and we should have our medication within 24-72 hours. I am REALLY praying that is the case and I am also really praying for the 24 hours so that we don't run out of the liquid keppra. I would really appreciate everyone joining me in prayer on this!
For now I am off to bed.... I'm exhausted!! Thank you for joining us in prayer. Let's pray tomorrow is the day we get her medication!
I have a friend who's had success with putting the pill inside a piece of macaroni so it is more slippery to go down better? They didn't need to use the macaroni for long, but it led to normal pill-taking. Good luck!
ReplyDeleteCan the pills be crushed and mixed with apple sauce or pear sauce? Check with pharmacist.
ReplyDeleteI mash a cracker in my mouth, then add the bad tasting pill, swallow with lots of water.