WHY WON’T MY INSURANCE COVER CONCERTA ? | ADHD Information

How is the Adderall XR 30mg's working for you? Do you feel motivated at all by it, or does it slow you down?My sister said a lot of people believe adult add or adhd doesn't exist.Maybe this is why. Tell insurance you want a written explenation of why some meds are covered and other aren't faxed to the Dr. daniel's mom38442.6738194444

Hi,

First off, I was initially prescribed concerta from my doc but when I went to get it filled, the pharmacist said my insurance doesn't cover it.  So I went back to the doc, and he gave me a prescription for ritalin 10mg 3x a day.  Went BACK to the pharmacy and they still said that I couldn't get the ritalin.  So I called my insurance and they said I needed a letter or "medical necessity" faxed to the insurance company stating a reason why and adult over the age of 21 needs a prescription for ritalin.  So, I thought okay, well the next visit I'll try concerta since that was the case and I figured my insurance covered it.  THe other day, I say my doc and he switched me to 36mg of concerta. So, I went to the pharmacy and STILL the same problem.  I called my insurance and they said that they don't cover concerta for people under the age of 21 and that I have to try another alternative like adderall or straterra.  Well, the ritalin worked great cause I just got a 90% on my recent exam and my last exam was bad, I got a D(before the meds).  So, I was confused about how they would allow ritalin but not concerta and that was their answer...because I have to try alternatives..either adderall or straterra.  So, since I'm out of meds, I went to the doc and he wrote my prescription for adderallxr 30 mg.  Why do you think that I wasn't "allowed" the concerta.  THeir explanation was not good enough.  BTW, I didn't take my meds today so I think was having a rough time understanding them, I dunno!  What do you think?

ditzychick38442.6387384259

Thanks Peck, I'll check out that idea.

And Johnny, I'll let you know

I am a pharmacy technician maybe i can help you with your insurance question. with my adderall  i had the same problem since i was over 17 (duh add doesnt stop at 17!). What you need to do is call your doctor tell him that you need him to fax a letter to you insurance company or "prior authorization"  .That you need this drug. sometimes it take 2 days sometimes 2 weeks. (mine took 2 weeks) and then once your doctor talks to the insurance and it all goes through then go to cvs and bring in your prescription and have them try to process it. everyday that your prescription is in the pharmacy the techs will try to put it through insurance until it goes though and is covered..