Retail Pharmacy Insurance Work Arounds

[Sparda29]

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Post your favorite overrides and whatnot for insurances here.

I have some patients who are on low cost insurance like Fidelis, Metroplus, Healthfirst, etc. Their doc prescribes them Viagra, Cialis, etc and of course it's not covered by insurance. So I get them the coupon for a free trial. Anyone know how to keep that free trial going. I know there is no way these guys are going to actually pay out of pocket for it.

 

[genesis09]

You can't keep the free trial going after the initial coupon. There are no legal work a rounds. The other option is to have physician write for sildenafil 20.

 

[Mcat14]

I knew a RPh who used to change DOB every time right before processing through to coupon, so patient can use multiple times coz some of those coupons, you can only use once in a year or month

 

[farmadiazepine]

Free trial will always work when you change the name of the patient. Give them a new name and do a telephone order for the Viagra or Cialis prescription. Illegal as hell. Not saying that I do it, but just a thought, right?

 

[Sparda29]

Free trial will always work when you change the name of the patient. Give them a new name and do a telephone order for the Viagra or Cialis prescription. Illegal as hell. Not saying that I do it, but just a thought, right?

Ehhh. Yeah not doing that.

 

[zelman]

Ehhh. Yeah not doing that.

Then what are you looking for?

 

[eagles22]

Higher dose and cut the tablet in quarters if possible? Get a diagnosis of pulmonary hypertension and pester insurance to cover Revatio?

 

[owlegrad]

Then what are you looking for?

I was thinking the same thing. If OP is not looking for illegal/unethical ways to get around limits, what is the point of the thread?

 

[Sparda29]

Higher dose and cut the tablet in quarters if possible? Get a diagnosis of pulmonary hypertension and pester insurance to cover Revatio?

Perhaps they would cover sildenafil 20 without pulmonary HTN diagnosis.

 

[zelman]

Perhaps they would cover sildenafil 20 without pulmonary HTN diagnosis.

Most insurances require them to use a specialty pharmacy for Revatio. I can't even get the rejection that they also need a PA.

 

[Wheresmyaricept]

I've seen 340b cover 30 tabs of cialis for like 7 bucks. But not the majority of birth control...which confuses me.

 

[huntermare]

You work at an independent, right? Are you allowed to price adjust? If so, just get a script for revatio 20mg, run it for cash and price adjust. Last time I checked cost was well under $1/tablet for the 20mg tabs so cash price on those are can be really cheap.