insurance won't cover zofran

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insurance won't cover zofran

Postby caseyhg » Jan 04, 2006 3:10 pm

What should I do if my insurance company wont cover my Zofran anymore? Before the new Year I ran out. My insurance company wouldn't pay for it so I had my doctor put in a request that they pay for more. It took days for it to get approved. I was so sick I had to drag myself to the pharmacy when it finally opened and I payed for it myself. $419.03!! I only have 4 pills left, 2 days worth. What if my insurance company refuses to pay for it? I'll end up in the hospital again. I don't know if I can take any more of this. I don't want to put my family through any more of this. I can't afford to spend $400 a week either! Has anyone else had this problen with insuance covering the Zofran?
Casey
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Postby JennyK » Jan 04, 2006 3:21 pm

Some people have gotten coverage for a zofran pump when zofran pills were denied. I didn't have a pump myself but some women here have reported it worked better for them than the pills.

I guess your doctor has to convince the ins co that it will cost them more if they let you get sick enough to be hospitalized than it would to just cover your prescriptions. It's so hard to fight with insurance when you are weak from HG.

Go to the zofran web site. They have a program to help people who can't afford it. I am not aware of anyone here actually having tried it, but give it a shot!
Jenny
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Postby aaronsmommy » Jan 04, 2006 5:10 pm

Unfortunately, the programs from the drug companies for zofran have not been successful for anyone. First, you really have to have no insurance coverage, second, using it for pregnancy is not a standard indication for the drug, and they won't approve you for that.

You might try the zofran reimbursement hotline, as far as I know no-one has tried it, but the idea is then they fight with the insurance company for you and your doctor. It's 1-800-699-3806

I did it the home health way, and it worked pretty well. Others have gotten much higher limits using mail order.
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