Why won't insurance won't cover day supply for medication for Nasonex?

Question

I went to CVS Pharmacy to get my prescription for Nasonex which contains 120 inhalations. My insurance covers a 30 days supply. I am using this spray once a day in each nostril which makes it a 60 day supply. I called the doctor and he said he only wants me to use one spray a day and to tell the pharmacy to put it as a 30 day supply so the insurance will go through. I called the pharmacy and they would not let it go for 30 days. I see the doctors point on how he does not want to change the prescription. I also see the pharmacist's point on how the calculation works. I need this medication and my copay is $10. Without insurance it would be about $100. When I call the insurance company, they tell the pharmacy to let it go for 30 days, but they won't because at the end of the year, the insurance would reject it again. What do i do?!?!?! Please help!!

Answer 1

Get the prescription changed to taking it twice a day, but in reality, only take it once a day. The default instructions for Nasonex is two sprays per day.

Answer 2

I think your doctor meant for the pharmacy to give you a 30 day supply. You will have to pay $10 every month to get it filled. That is why your insurance wants to to fill it every 30 days; if you filled int every 60 days the insurance company would be at a $10 loss per customer (the cannot charge you a higher co-pay). Call your insurance company they can probably get you on a automatic ship program. That's how I get my meds from my cheap insurance company. My meds come in the mail once per month and I'm billed my copay.

If CVS does not fill your RX for 30 days, call 1800-Shop-CVS or go elsewere. Your doctor choices what your RX will be, not the pharmacy.