Insurance Coverage of Triptans
Insurance is an ongoing nightmare for practically everyone. If you need more triptans (a common type of migraine abortive) a month than your plan allows, you’re in for a real hassle. Without insurance they are, of course, mighty pricey.
Kathy, a reader, is faced with a new bureaucratic hurdle that I’ve never seen before. Her story follows. She’d appreciate any advice you can give.
I just had to share this with someone that could understand, and maybe you have some suggestions as to whether anything can be done. I was just informed by my insurance company that I can now only get 4 Maxalt tablets at a time. I can get 8 per month (down from the 9 per month it used to be) but I have to go in to the pharmacy TWICE per month. Maxalt is the least troublesome of the triptans for me and enables me to keep working with a migraine. My migraines usually last 3 days (requiring 6 Maxalt) and CAN last 5 – 6
days. It is so infuriating that an insurance company can do this.
Their explanation was that studies have shown that most people (?) only refill their prescription of 9 tablets once every 3 months. 38% of the prescriptions are never refilled. So they decided that 3 pills is a 30 day supply. Have you ever heard of anyone being successful in fighting something like this? Any ideas on what to do?
Even if you don’t have suggestions for Kathy, eave a comment with your story — whether good or bad — about getting the meds you need. I and other readers will certainly benefit from your experience.