Antihistimines

[Jacquie802]

Hi guys,

Just curious to see if anyone else has a problem with their insurance covering allergy meds. My insurance does not cover any of them. My PCP wrote out an RX for allegra and it won't be covered. Obv. I don't have the money to pay for it every month...Anyone got any ideas for me or have had the same prob? Thanks

[Sunfish]

i haven't dealt with this myself but do know that some insurance companies instituted policy changes when some allergy meds that had previously been prescription became available over the counter. though different meds may work better for different people, generally speaking claritin is considered to be the same type/classification/family of med as many of the prescription options (clarinex, allegra, etc). thus the insurance companies can justify - from a legal standpoint - not covering these medications. i'm not saying i agree or that i think it should be allowed but rather am just trying to explain a bit.

while buying OTC claritin is by no means cheap (and cumulatively likely to be a lot more than some Rx co-pays), it's probably still a lot cheaper than allegra or other prescription options if paid for out of pocket. likely the only way that your insurance MIGHT pay for allegra would be if there is a specific & quantifiable reason that you cannot take claritin (or another OTC option). your doctor would have to document this & even then they may still not pay b/c as long as a company has the same policy for everyone they can choose not to cover certain classes of medication. there may be some exceptions, such as if not having a med would be life-threatening (i.e. someone with severe asthma triggered by allergies) but this wouldn't apply for most people with "just" allergies.

in the end, you may want ot call your insurance company and ask them if there are ANY cirumstances under which allegra (or another allergy med) would be covered. they may try to give you the run around but you should be able to get some answer out of them.

last but not least, you may want to splurge on just a few pills of allegra to see if it helps you. there's no rule saying you have to buy enough for a month or even a week & it's a quick-acting med that doesn't need to build up in your system. while you probably need a few days to allow for day-to-day variations (both in autonomic symptoms & allergies) you would then at least know if it's a med worth pursuing. it would be a shame to waste time & energy trying to get something that either doesn't help or makes other things worse in the end. if you decide to give this a try, know that pharmacy differ vastly in their pricing; it would definitely be worthwhile to make a few phonecalls (&/or check online) for the best out-of-pocket cost.

hope this helps,

melissa

[Jacquie802]

Hi Melissa,

Thank you for your reply. It's good to see youb ack here . My allergies are pretty bad to the point my throat swells up and I get palpitations, etc. My allergist has given me an RX for epi-pen since we still aren't sure what's causing this reaction in me. I'm gonna try to muster up the energy to fight with the insurance company...Thanks again!

Jacquie

[ellen]

Jacquie, I use fexofenadine, generic for Allegra, and my insurance covers that. I had been using Clarinex (great stuff) but the insurance didn't cover it, so I asked my doc for 180 mg (max strength) generic instead. I also use store brands of "Claritin", which occasionally goes on sale, and needs no Rx.

Have you asked your doc for samples? Mine gave me a handful before to try before I got a prescription. Don't be afraid to ask! Good luck, Ellen

[Aprilmarie52]

My mom has had the same problem with her antacids. The ins company says that the over the counter ones are just as good as the prescription ones. Why would they be prescription only if they were the same thing? My insurance company doesnt cover my brand of prenatal vitamins (ones that dont make me sick) because they say there are cheaper alternatives. Your dr can write a letter asking that the insurance company cover the Allegra for medical reasons, but they dont always get approved.