View Full Version : insurance company won't cover Quillivant


leaveycelena
12-14-16, 06:27 PM
after receiving the prior authorization form from our pediatrician our insurance company denied it and won't cover this stuff. Our son is doing really well on it, but man it's not cheap. Any experience with finding a generic alternative? THANKS IN ADVANCE.

sarahsweets
12-17-16, 10:09 PM
I am not familiar with it. Is it similar to ritalin? Or is it similar to amphetamines?

Little Missy
12-17-16, 10:17 PM
after receiving the prior authorization form from our pediatrician our insurance company denied it and won't cover this stuff. Our son is doing really well on it, but man it's not cheap. Any experience with finding a generic alternative? THANKS IN ADVANCE.

You can appeal it. Call every day and continue to have your doc fax it and they'll approve it. Don't give up.

ToneTone
12-18-16, 12:44 AM
Just from a quick search, Quillivant is a liquid form of methylphenidate ... so that's just Ritalin to use the most commonly used word.

So yes, there are a lot of generic methylphenidate medications out there, and that may be one reason your insurance company doesn't want to pay for this new formulation. But as the earlier responder said, appeal and appeal and get your doctor involved.

If the doctor prescribed this new formulation of methylphenidate most likely they have had experienced with insurance companies covering and not covering it. So tell the doctor the medicine isn't approved and ask what they can do to help you. Might be a separate note from the doc will do the trick.

And to answer your question yes there are several long-acting versions of methylphenidate that are in generic form.

Do a google search for long-acting methylphenidate ... or extended-release methylphenidate. Just for background, long-acting meds are taken usually once a day and they are specially designed to release the medication over time. There are also short acting versions of methylphenidate. But you have to take those short-acting versions two times a day usually. Some people prefer one to the other. I point you to generic long-acting because Quillivant seems to be in that category.

Good luck.

Tone

leaveycelena
12-21-16, 06:24 PM
Thanks,I appreciate it. Talked to doctor today and the drill is we have to try the methylphenidate in pill form, we found one that lasts 8 hours, and will be covered. If for some reason he doesn't do well on it, the. We go back and insist that the insurance company covers it. Thanks for advice.

Caco3girl
12-22-16, 09:05 AM
Thanks,I appreciate it. Talked to doctor today and the drill is we have to try the methylphenidate in pill form, we found one that lasts 8 hours, and will be covered. If for some reason he doesn't do well on it, the. We go back and insist that the insurance company covers it. Thanks for advice.

It's an insurance dance most of us have had to do, sadly. For my son the Doctor prescribed Concerta, the insurance company said "We will not cover concerta UNTIL you have tried Vyvanse and Aderall XR".....so we wasted about 3 weeks proving the others didn't work and then poof Concerta was allowed and it DID work....just had to roll my eyes at that one.

meesie
01-21-17, 07:06 PM
They have a co pay card
https://www.quillivantxr-quillichewer.com/savings-and-support/co-pay-card

You will not pay more than $25

I have had the $20 co pay card for 2 years. They just raised it to $25

Just fill out the info correctly, you will have the temp. card to print & they will mail the perm. card in 7-10 days.

Make sure you use a pharmacy that takes the card. :)

asthma
01-21-17, 11:32 PM
insurance companies blow