Is there any way to get medication paid for that I need and my insurance won't cover?

Question

I have Multiple Sclerosis, am constantly fatigued and was taking provigil(modafinil) to help me until my insurance stopped paying for it. It costs @ $250/ month and I support my 2 kids on disability and child support ($950/month). Is there anywhere that I can go to help me with this expense? My quality of life is greatly reduced without it.

Answer 1

Have you told your doctor? S/he should be able to contact your insurance company with an in depth explanation of why you need this particular medication. Good luck to you.

Answer 2

You have already gotten many very fine answers. I salute all of you who jumped in to help this person.

Insurance companies have a list of medications that they will cover and this is called a formulary. Medications are added to formularies and they are droppped from them as well. It may be that your insurance company has dropped Provigil. If this is the case, speak to your doctor about getting prior authorization. Your doctor must provide justification for approval.

It is true that some pharmaceutical companies will provide medications free of charge or at a reduced rate. Provigil is from a company called Cephalon and they do have a website with contact information. Go to it. If they offer such a program you will be sent an application form that you and your doctor will complete. And ask your doctor about a substitute, perhaps dextroamphetamine sulfate, to help with your fatigue in the meantime.

Answer 3

Try contacting the Provigil Reimbursement Assistance Hotline at 1-800-675-8415.

There's also the Partnership for Prescription Assistance, which has an online application wizard which will help find programs you may qualify for to get your medication.

Best of luck to you and your family.

Answer 4

I have listed a couple of links below; check with your doctor's office; most of the time they can also give you some contacts also. There are many assistance programs available now to help people with medicines. You might also try contacting the manufacturer directly. Many drug companies also have programs, but they do not widely advertise it. Good luck and Godspeed.

Answer 5

A rep at Medicare told me that Walmart pharmacy has some type of program. I didn't check on it because it wasn't necessary for me. When she described it, it sounded like a "type" of insurance. I'll have to check it out for future reference. Give them a call and find out if she was right.

Answer 6

Not unless you have a secondary insurance carrier. Meds are so expense now a days. Have you tried applying for medicaid, so they can help with the medical bills and prescriptions?

Answer 7

I have heard of people that have actually contacted the drug company that produces the medication and explained their situation. Depending on the situation, some companies are willing to provide it for free or at least at a discounted price. Try that.

Answer 8

I have a medical card specific to my county that I can use to get medications at a fraction of the price. It is available to people who cannot afford their meds. You should call the welfare office in your county to see if you have a similar program in your area.

Answer 9

Try writing to the drug company. My mother gets a couple of her meds free this way. If you explain your hardship and your need for the drug, they will often give it to you free or reduced price. Also check with the doc and see if he can give you some sample packs. Good luck and God bless.

Answer 10

Try connection to care .Call [phone]. Good Luck I hope I could help.