Insurance and GH question...

[Guest guest]

With my insurance I pay a $120.00 copay and get a 90 supply of my meds. This

includes Liam's GHT. He is on Genotropin. Now I realised after the 2nd time

I had to change his cartridge that they did not send me enough.... I have to

change it after the 8th shot.. They sent me 11 cartridges... That's 88

days... I could do what my friend does and on the day I change the cartridge

give him two shots, but I don't think it is worth it because it only had .1

left in it after 8th shot...

I called the drug company (Tele- Drugs) and I spoke to the same guy who has

helped me before.... This is what he said.. That because of the way the

drug is packaged there is nothing they can do. My insurance will not pay for

12 cartridges, because that would be 99 days worth of med. since I am able

to refill after 2 months and not have to wait a full 90 days to refill I

will never run out... Well, I don't like that answer because I am still

paying for 90 days, and not getting it. So really they are shorting me 1

cartridge a year.. Should they send me 1 shippment with 12 cartridges? I do

not know how I would get them to do this.. But the way I look at it is Tele

Drugs is making a profit here, more so then what they already do...

Is there anything I can do??? Besides complain to you and sit back and let

it happen...

Mom to Liam (3 1/2 years old 34 3/4 " 27 lbs

SGA, Hypothyriod, Epilepsy.) Started GHT 5/18/04

and Jed (11 years old)

SW Orlando FL

[Guest guest]

Hi,

I know Good Housekeeping has a column where they tackle these issues. I also

always go to m y local House rep or Congressperson. They sometimes can give

advice. Maybe your doctor will increase the prescription amount so that you can

get the cartridge? - have you asked him/her?

Insurance and GH question...

With my insurance I pay a $120.00 copay and get a 90 supply of my meds. This

includes Liam's GHT. He is on Genotropin. Now I realised after the 2nd time

I had to change his cartridge that they did not send me enough.... I have to

change it after the 8th shot.. They sent me 11 cartridges... That's 88

days... I could do what my friend does and on the day I change the cartridge

give him two shots, but I don't think it is worth it because it only had .1

left in it after 8th shot...

I called the drug company (Tele- Drugs) and I spoke to the same guy who has

helped me before.... This is what he said.. That because of the way the

drug is packaged there is nothing they can do. My insurance will not pay for

12 cartridges, because that would be 99 days worth of med. since I am able

to refill after 2 months and not have to wait a full 90 days to refill I

will never run out... Well, I don't like that answer because I am still

paying for 90 days, and not getting it. So really they are shorting me 1

cartridge a year.. Should they send me 1 shippment with 12 cartridges? I do

not know how I would get them to do this.. But the way I look at it is Tele

Drugs is making a profit here, more so then what they already do...

Is there anything I can do??? Besides complain to you and sit back and let

it happen...

Mom to Liam (3 1/2 years old 34 3/4 " 27 lbs

SGA, Hypothyriod, Epilepsy.) Started GHT 5/18/04

and Jed (11 years old)

SW Orlando FL

[Guest guest]

<<Maybe your doctor will increase the prescription amount so that you can

get the cartridge?>>

I highly doubt it he's an *** (you can fill in the blanks!!)

But thanks....

Mom to Liam (3 1/2 years old 34 3/4 " 27 lbs

SGA, Hypothyriod, Epilepsy.) Started GHT 5/18/04

and Jed (11 years old)

SW Orlando FL

[Guest guest]

I'm sorry! My kids pediatrician is awesome! She is absolutely the best as far

as doing what helps for the kids, including writing letters, calling insurance

herself etc.

4.5 and Emerence almost 16 mo. (SGA RSS????)

Re: Insurance and GH question...

<<Maybe your doctor will increase the prescription amount so that you can

get the cartridge?>>

I highly doubt it he's an *** (you can fill in the blanks!!)

But thanks....

Mom to Liam (3 1/2 years old 34 3/4 " 27 lbs

SGA, Hypothyriod, Epilepsy.) Started GHT 5/18/04

and Jed (11 years old)

SW Orlando FL

[Guest guest]

I LOVE my son's ped and would not stay with a Ped that I didn't like and

have switched before..... ... But the Endo. is the jerk and He is the only

one in Orlando, so I can not switch, even though I would in a heartbeat!

Mom to Liam (3 1/2 years old 34 3/4 " 27 lbs

SGA, Hypothyriod, Epilepsy.) Started GHT 5/18/04

and Jed (11 years old)

SW Orlando FL

[Guest guest]

How awful not to have a choice! Hopefully someone will move into the area. We

are so blessed here in MA to have Boston's Children's Hospital. Some idiot

ortho told me the other drs who diagnosed my son with hypotonia/low muscle tone

were wrong that it didn't exist. I was lucky I had about 10 other drs in the

same dept to switch to! I am so sorry! I hope you are blessed with a new great

endo soon!

, mom to 4.5, Emerence almost 16 mo. 16 lb 11 oz

Re: Insurance and GH question...

I LOVE my son's ped and would not stay with a Ped that I didn't like and

have switched before..... ... But the Endo. is the jerk and He is the only

one in Orlando, so I can not switch, even though I would in a heartbeat!

Mom to Liam (3 1/2 years old 34 3/4 " 27 lbs

SGA, Hypothyriod, Epilepsy.) Started GHT 5/18/04

and Jed (11 years old)

SW Orlando FL

[Guest guest]

We have EXACTLY the same problem, but even worse. Aetna ships us

a " 30 day " supply, but because our vial gives us about 12 days

worth, we only get TWENTY FOUR days worth instead of 30. So we are

paying for an extra 3 shipments a year (instead of 12 shipments we

need 15).

Now, that being said, having exhausted my phone calls when this

clearly makes NO sense whatsoever (ship us longer amounts less often

makes the most sense) -- my husband reminded me that at least our

insurance is covering the GH.

Your copay of $120 means $480 a year, with basically one extra week

that you will have to pay. I don't know what dosage you guys are

at, but 's growth hormone according to a bill I saw runs

about $15,000 a year. So we are paying $320 a year for $15,000 of

medicine -- and a medicine that some insurance companies don't pay

for at all.

So..... I have decided that although it doesn't technically make

sense, and there are such simply ways to fix it, we aren't going to

fight it. Now, Jodi Zwain's issue of insurance companies not paying

for the cans of Pediasure or whatever goes into the G-tube feeding,

yee gads!!!! You are right that it doesn't make sense though.

> With my insurance I pay a $120.00 copay and get a 90 supply of my

meds. This

> includes Liam's GHT. He is on Genotropin. Now I realised after the

2nd time

> I had to change his cartridge that they did not send me enough....

I have to

> change it after the 8th shot.. They sent me 11 cartridges...

That's 88

> days... I could do what my friend does and on the day I change the

cartridge

> give him two shots, but I don't think it is worth it because it

only had .1

> left in it after 8th shot...

> I called the drug company (Tele- Drugs) and I spoke to the same

guy who has

> helped me before.... This is what he said.. That because of the

way the

> drug is packaged there is nothing they can do. My insurance will

not pay for

> 12 cartridges, because that would be 99 days worth of med. since I

am able

> to refill after 2 months and not have to wait a full 90 days to

refill I

> will never run out... Well, I don't like that answer because I am

still

> paying for 90 days, and not getting it. So really they are

shorting me 1

> cartridge a year.. Should they send me 1 shippment with 12

cartridges? I do

> not know how I would get them to do this.. But the way I look at

it is Tele

> Drugs is making a profit here, more so then what they already do...

> Is there anything I can do??? Besides complain to you and sit back

and let

> it happen...

>

> Mom to Liam (3 1/2 years old 34 3/4 " 27 lbs

> SGA, Hypothyriod, Epilepsy.) Started GHT 5/18/04

> and Jed (11 years old)

> SW Orlando FL