Drug therapy is currently the most effective way to treat Parkinson’s disease. If you are fortunate to have insurance that covers prescription drugs, you need to pay careful attention to what it covers.
Your insurance company may provide you with a drug formulary, or a list of commonly prescribed drugs that are preferred over brand name drugs. The effectiveness, safety, and cost of the drugs on the formulary appeal to doctors and patients.
It is best not to use mail order pharmacy coverage when your doctor prescribes a generic drug. Ask for a prescription for a 30 day supply and fill it locally at a pharmacy.
You can tell how effective most drugs are after about two weeks, but check with your doctor for that information. If the generic works as well as the brand name, you can use mail order to receive a couple months supply of the drug.
Be sure to read the benefits section of your drug coverage; insurance coverage varies from company to company. Here are some examples of some insurance policy requirements:
- Fill prescription at a pharmacy if the medicine will be taken short-term. Your insurance company may provide you with a list of pharmacies that participate in your insurance plan.
- Use mail order benefit if medicine is for the long-term.
- Note if you have a deductible or co-pay.
- Note if you have an annual maximum cap that combines retail and mail order costs.
- Note if a claim form needs to be submitted with your prescription at a pharmacy that does not participate with your insurance plan.
- Regulations for dispensing drugs vary from state to state. In my state, the actual quantity of controlled medication prescribed by the doctor must be filled for one year or six months. Keep this in mind and review your prescription before filling it.
- An example of actual quantity follows: Your insurance plan has a limit of 90 pills per fill but your doctor writes a prescription for 100 pills. The 10 pills remaining constitute a partial fill. On your last bottle of the 90 pills will be a partial fill notation. That means when you fill the partial refill of 10 pills you will still be charged the amount you paid for 90 pills.
- Most prescriptions are by law limited to a one year supply. The prescription from your doctor is for 90 pills with four refills. You take the initial 90 pills and three refills for a total of 360 pills. Only six days worth of pills can be dispensed. The 366 pills are the one year supply limit.
- Review your prescription before filling it.
Get the most out of your drug benefits by reading through your insurance policy.
