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PostPosted: Tue Jan 24, 2017 6:03 pm 
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I've been clean and on a form of buprenorphine 3 years now and I have a great relationship with my doctor and pharmacy. As a former pain pill addict, it's been such a relief not having any issues with either of them. But now my health insurance provider, United Healthcare is throwing a wrench in it all and I'm at my wits end.

Effective December 2016, they've implemented a 15 tablet a month quantity supply limit. I take one 8mg tablet a day and now only half of that is covered. I don't even understand how they could put less than a 1 tablet a day max on medication! And while it appears my doctor can submit a pre-authorization requesting to override this limit, neither he nor the pharmacy seem to be able to figure out how. It's so frustrating because it's the patient that suffers yet I have absolutely zero control over getting this accomplished.

I really just wanted to vent so thanks for listening!


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PostPosted: Tue Jan 24, 2017 11:49 pm 
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Joined: Fri Nov 25, 2011 6:14 pm
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Location: Petoskey, MI
What is even more irritating, is they have no problem covering vicodin,percocet,methadone,......

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PostPosted: Wed Jan 25, 2017 12:25 am 
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NYJets0714 wrote:
I've been clean and on a form of buprenorphine 3 years now and I have a great relationship with my doctor and pharmacy. As a former pain pill addict, it's been such a relief not having any issues with either of them. But now my health insurance provider, United Healthcare is throwing a wrench in it all and I'm at my wits end.

Effective December 2016, they've implemented a 15 tablet a month quantity supply limit. I take one 8mg tablet a day and now only half of that is covered. I don't even understand how they could put less than a 1 tablet a day max on medication! And while it appears my doctor can submit a pre-authorization requesting to override this limit, neither he nor the pharmacy seem to be able to figure out how. It's so frustrating because it's the patient that suffers yet I have absolutely zero control over getting this accomplished.

I really just wanted to vent so thanks for listening!


I have United Healthcare too. They suck much of the time. Do you take Zubsolv? I had to change to it per their requirement. The thing with them is be persistent!!! Call and keep asking for someone to help you find out how to get a prior authorization with them. Ask them for the number your doctor needs to call or fax. I ended up asking the rep I was on with if there was a secret language that had to be used to find things out!! Here's another tip. Make sure your doctor writes "expedite" somewhere on the forum. Otherwise they will tell you that they have up to 15 business days to make their decision regarding the authorization. Be polite, but be pushy. They need to know that you're not getting off the phone until you get the info you're looking for.

Good luck!

Amy

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