Epipens and Insurance Coverage

Posted on: Sat, 12/23/2006 - 7:18am
Going Nuts's picture
Offline
Joined: 10/04/2001 - 09:00

This week I got a letter from my health insurance company (Oxford) informing that as of January 1, 2007, epipens will no longer be a Tier 2 drug. They will move to Tier 3 (meaning we'll have to pay a higher copay) and that they want us to use Twinject instead.

I voiced my complaint by telephone, but haven't gotten around to writing yet. I'll do that this weekend.

Has anyone else gotten one of these notices? Any other insurance companies doing the same thing?

If you don't like it, please write and let them know!

Amy

Posted on: Sat, 12/23/2006 - 7:41am
Carefulmom's picture
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Joined: 01/03/2002 - 09:00

It hasn`t happened to us yet, but I find it really annoying. I personally think that the Twinject is much harder to use. It is hard enough for a teacher to remember how to use an epipen correctly during the panic of a reaction. I would not be at all comfortable having Twinjects at school, although I might be comfortable having them on me, and practicing frequently with the trainer. If our insurance company does that, I`ll continue to get the regular epipens for school and just pay out of pocket. They are much easier to use.

Posted on: Sat, 12/23/2006 - 10:51pm
Anonymous's picture
Anonymous (not verified)

Our insurance company never informs us in advance when they change coverage of medicines. When I go to fill a prescription the pharmacist tells me. [img]http://uumor.pair.com/nutalle2/peanutallergy/rolleyes.gif[/img] This often results in phone calls between pharmacist and doctor (depending if there is something acceptable covered, and how much I have to pay).
Many years ago our insurance decided they were not going to cover epi-pens because the Anakit was cheaper and had two doses of epinephrine. It was in a syringe with two doses, you had to get the air bubbles out of syringe, inject, and push plunger half-way.
Even letters from doctors had no effect on the coverage. They were not telling people what prescription to get filled -- they were only decided what they would pay for. When allergists finally got the Anakit taken off the market the insurnace started covering the Epi-pen.
I expect when I refill my prescription next year they will only cover the twinject.

Posted on: Sat, 12/23/2006 - 11:46pm
saknjmom's picture
Offline
Joined: 04/02/2003 - 09:00

I just refilled epi pens with no problem. My allergist told me he would only refill with twin ject. when pharmacy called for okay to refill, they didn't change it.
Insurance paid usual amt.
we have healthnet.

Posted on: Sun, 12/24/2006 - 1:54am
momll70's picture
Offline
Joined: 09/26/2006 - 09:00

Same thing happened to us. Me and my son both have epi-pens. I'm waiting for the letter regarding my epi-pen. We have Oxford also. This is the second medication I have to pay more money for and I'm not happy. Insurance companies are such rip offs.

Posted on: Sun, 12/24/2006 - 1:57am
momll70's picture
Offline
Joined: 09/26/2006 - 09:00

I will write and let them know but I honestly think that they don't care. It's all about money to them. Although I like my insurance company for other reasons, the prescriptions coverage is ticking me off.

Posted on: Sun, 12/24/2006 - 2:45am
NicoleinNH's picture
Offline
Joined: 06/21/2003 - 09:00

***
[This message has been edited by NicoleinNH (edited June 10, 2007).]

Posted on: Sun, 12/24/2006 - 3:29am
patsmommy's picture
Offline
Joined: 10/31/2001 - 09:00

I have oxford too and got the same letter.
I am planning on renewing my epipen next week before the co payment goes up. Waiting for his singular and zrytec copayments to go up too now.
oh and I got a letter from oxford that starting jan 1st I can't go to quest lab anymore.

Posted on: Sun, 12/24/2006 - 9:17am
Going Nuts's picture
Offline
Joined: 10/04/2001 - 09:00

Quote:Originally posted by patsmommy:
[b]
oh and I got a letter from oxford that starting jan 1st I can't go to quest lab anymore. [/b]
Yes, I received that one yesterday too. Not happy about that one either, since they are by far the most convenient around here.
Amy

Posted on: Sat, 12/23/2006 - 7:41am
Carefulmom's picture
Offline
Joined: 01/03/2002 - 09:00

It hasn`t happened to us yet, but I find it really annoying. I personally think that the Twinject is much harder to use. It is hard enough for a teacher to remember how to use an epipen correctly during the panic of a reaction. I would not be at all comfortable having Twinjects at school, although I might be comfortable having them on me, and practicing frequently with the trainer. If our insurance company does that, I`ll continue to get the regular epipens for school and just pay out of pocket. They are much easier to use.

Posted on: Sat, 12/23/2006 - 10:51pm
Anonymous's picture
Anonymous (not verified)

Our insurance company never informs us in advance when they change coverage of medicines. When I go to fill a prescription the pharmacist tells me. [img]http://uumor.pair.com/nutalle2/peanutallergy/rolleyes.gif[/img] This often results in phone calls between pharmacist and doctor (depending if there is something acceptable covered, and how much I have to pay).
Many years ago our insurance decided they were not going to cover epi-pens because the Anakit was cheaper and had two doses of epinephrine. It was in a syringe with two doses, you had to get the air bubbles out of syringe, inject, and push plunger half-way.
Even letters from doctors had no effect on the coverage. They were not telling people what prescription to get filled -- they were only decided what they would pay for. When allergists finally got the Anakit taken off the market the insurnace started covering the Epi-pen.
I expect when I refill my prescription next year they will only cover the twinject.

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