What is Myasthenia Gravis
Myasthenia gravis (MG) is a neuromuscular disease leading to fluctuating muscle weakness and fatiguability. At about 14 cases per 100,000 (in the U.S.), it is one of the lesser kno...
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Hi everyone,
I'm a newly diagnosed MG'r and happy to have found this group. I have a question regarding Mestinon Timespan for those of you with Insurance. I just found out that my insurance will not cover it because the standard Mestinon has a generic version. I understand that rationale for people that want it for convenience but I take regular Mestinon during the day and my neuro just ordered it b/c I have extreme weakness in the morning. I have severe MG with diaphragm and intercostal muscle involvement and it has gotten so bad that by the time I wake up I am either paralyzed (can't walk, talk, open my eyes) or so weak that I fall when I try to stand and sound intoxicated. Once the Mestinon has fully gotten into my system I recover but I can't take this daily roller coaster much longer and don't know how I'll ever be able to go back to work again if I wake up paralyzed?? Any help/suggestions would be very appreciated. Thx, Jen Posted on 10/27/09, 07:10 pm |
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JenL77
You can call your insurance co and see if they will make an exception. Ask them if you need your doctor to call them or write them a letter. Give it a shot!! Thanks Dawn 
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Most insurance companies have a process for appeal. Make sure they know that there is no time-release option n the generic market. And tell them that this could keep you out o the hospital. This will be a life-saver for you until you get get out of this crisis.
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I agree. Your doctor's office should intervene and get this approved for you. Also, your pharmacist could give it a try also. Good luck. Sarah
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Both of the responses that are here are good one's but I think you should just get your doctor to right a prescription for you stating why you need this so that when your insurance gets it they will see that this is a life or death situation and you need this medicine and if that doesn't work then you can talk with your pharmacist and work out an arrangement to where you pay for half the medicine at a time.. just try to keep it to a point to where you never run out. Try buying 2weeks of medicine at a time like get it according to when you get paid...If you takl with your pharmacist and your doctor Im sure something can be worked out. I know here in louisiana at the hospital where I go their is a prescription plan for those who can't afford the medicine out of pocket.. You have to look into this and being that you have MG so bad you should look into getting disability and that way you will get medicaid insurance and medicaid will indeed pay for it (speaking from experience) I take mestinon and I dont pay anything but a co-payment of I think like 2 or 3 dollars... for a 2 to 3 week supply due to how I take them ( 2 pills every 4-6hrs) I can get my prescriptioin filled twice in one month...You have to make sure you speak up...Tell them what it is you need and want done...
take care sweetie :) your in my prayers...
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Your doctor should be able to speak on your behalf. I'm not about the insurance though, because i have insurance through my job and it only covered copay once a month and if i want to get more i have to pay full price for it.
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I take the generic during the day and the Timespan at night. My insurance pays for both of them. The co-pay is more expensive for the Timespan. They are differeent as there is no generic Timespan. I would argue the point with insurance.
Good luck!
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Thank you for your responses everyone. The doctor and pharmacist have both explained to the insurance company why I need the Mestinon Timespan at night. They are reviewing it and will have an answer next week. In the meantime I bought $40 worth (10 pills) which is equal to my co-pay for non-generic meds. If the insurance approves I will receive the remainder of the script (20 pills) at no additional cost. If they don't, the manufacturer has a perscription assistance plan that I can apply for and if that is not approved my local MG chapter said they have some resources they can pull from. I just want to be well and I don't understand how a drug that has been on the market for sooooooo long doesn't have a generic. My Imitrex already has a generic and that came out in the late 90's...sorry for the rant at the end. I just don't have the energy to go through all these hoops. I am thankful that there are other programs out there to help me get the medicine I desperitely need. When i talked to the insurance today I said it would be way less expensive for them to cover the prescription than it would to pay for a hospital stay, they didn't get it...oy, yoy, yoy! have a good night everyone, time to take my timespan and get some much needed zzzzzzzzzzzzz's:)
Jen
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