Today my new primary Dr gave me sample pack of Viibryd. I told her that my insurance wouldn't pay for drug but she said well you've tried many of the others so it should. My B/C medicare plan only pays for generic. Any ideas or do I call tomorrow and get different drug. In the past I've taken Cybalta, Lexapro, venlafaxine and Prozac. I am down in the dumbs as it is taking so long to get diagnosis for lungs. They told me in June the CT showed interstitial lung (PF). The second scan showed it was somewhat clearing,O2 70% at night(based on night O2 study) and was 92 during day. So I'm still waiting on sleep study which is Sunday. I have had severe chest pains for 6 months. Pretty much ruled out heart from echo. I have a number of other serious issues going on but I can't take the wait anymore. Anybody have any suggestions on a drug that might work sooner. I don't like pain pills but she did give me muscle relaxers-haven't tried today. Thanks Peggy
The best thing to do is get out the insurance card that pays for your medications and call the customer service line and find out why it isnt covered. Sometimes it is because they want you to try other less expensive medications first (and your Dr needs to document what was tried and why it failed), sometimes it is just a matter of getting prior authorization in which your Dr has to contact the company and answer questions or whatever they require, then ask them what you can do to get this medication covered. There is usually an appeal process that you can try to see if they can make some kind of exception for you since you have tried so many other drugs. You may need to get your Drs help in the appeal process but first things first is to call your insurance company. As a case manager for a health insurance company, I do this sort of thing all the time.
Every insurance company is different in what they cover and dont cover and they each have different appeal processes but very little is ever written in stone and exceptions can be made but you may have to do some leg work to get it done. If your insurance company offers a case manager, get into contact with him/her and they can help you. many companies have a CM assigned to cases. In getting exception, you cn expect to pay the highest copay that your company has. Sometimes they will even make exceptions on that. It never hurts to call your insurance company and ask questions, always about many things. Dont just except no for an answer because many times these exceptions can be made if a person is willing to do the leg work. The insurance company counts on the fact that most people dont like the hassle and bother of getting the most out of their coverage because that saves them money! Best of Luck! :-)
I keep trying to answer you and its not posting. If you google forest pharmaceuticals you will find an assistance site. You can apply for help, and get more samples from the dr meanwhile.
Peggy, Viibryd is an SSRI as are the Prozac and Lexapro which you have already tried. I would ask your doctor what is so special about Viibryd as opposed to other SSRIs such as Celexa (generic: Citalopram) and Zoloft (Sertraline) which do come in generic. Just because the doctor gets some free samples doesn't mean that Viibryd is the one for you to take. Doctors tend to promote the drugs that they get free samples of. Also I take about 40 mg of Baclofen (a muscle relaxant) which I've had no side effects from. And I have a very long list of meds that I am allergic to. The Baclofen has taken away severe pain that I had in my mouth and face. Good luck to you.
Viibryd still has a discount card available. See if your doctor has one or contact them.Their contact info in on this site. It does not last forever, but it is better than nothing. With insurance it still cost me $75/month.
I take two medications that are not covered. My doctor sends a prior auth request with the history of things tried and my condition. They pay for it. I Also have secondary insurance which further reduces the cost.
It is up to the doctor to request payment for your treatment.
- Viibryd Information for Consumers
- Viibryd Information for Healthcare Professionals (includes dosage details)
- Side Effects of Viibryd (detailed)
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