Retail Pharmacy Insurance Work Arounds

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.

Sparda29

En Taro Adun
Lifetime Donor
15+ Year Member
Joined
Mar 25, 2008
Messages
9,848
Reaction score
1,835
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.

Members don't see this ad.
 
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.
 
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
 
Members don't see this ad :)
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?
 
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.
Most insurances require them to use a specialty pharmacy for Revatio. I can't even get the rejection that they also need a PA.
 
I've seen 340b cover 30 tabs of cialis for like 7 bucks. But not the majority of birth control...which confuses me.
 
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.
 
Top