View Full Version : Adderall prescription through low income insurance in US


electric76
08-05-17, 03:06 PM
Been awhile since I posted here! At that time I had Kaiser through my parents. Now I am 28 and insured under Medi-cal. I have not had my Adderall prescription for over two years and I'm still suffering.

I've been trying to find a way to be prescribed Adderall for over a year now. I know Adderall isn't available for those over 18 unless there is special authorization from a psychiatrist. So I looked up mental health clinics covered by my insurance and what do you know....they're all nurse practitioners and psychologists who would not be qualified to write prior authorization. What a catch-22.

Well today, I went another route and found ONE psychiatrist covered by my plan. ADHD is listed under his conditions he treats. I'm wondering, would he have to treat me with other ADHD prescriptions before saying I need Adderall? I tried Ritalin and Wellbutrin in the past and they didn't work. I can even get my health record to show him. I can also get him in contact with my therapist I've seen nearly 2 years. Does that help?

Also the formulary says only 1 Adderall XR per day is permitted...so a max of 30mg. I used to take 50mg IR because for some reason I experienced shorter duration than typical. Adderall IR isn't mentioned (although it is available for those under 18). Dexedrine you can have 2 per day. ANYWAY there IS an asterisk that says "Requests for quantities above indicated Quantity Limits will be reviewed on a case by case basis" . If I have to be prescribed XR I hope I can AT LEAST get 40mg, which would be 2 20mg. If they quantity limit isn't approved, can the PDoc still prescribe it to me and have me pay full price?

If I am authorized for my full adderall prescription much does low income insurance typically cover? Let me know any of your experiences please!!

BlackWarrior
08-05-17, 04:35 PM
Medi-cal will cover your adderall prescription (up to 40mg for IR) if you have Health Net and have your prescription filled at Rite Aid.

You might have to pay out of pocket to see a specialist since most psychiatrists who accept medi-cal are not likely to prescribe scheduled IIs. I could be wrong though.

electric76
08-05-17, 06:14 PM
Medi-cal will cover your adderall prescription (up to 40mg for IR) if you have Health Net and have your prescription filled at Rite Aid.

You might have to pay out of pocket to see a specialist since most psychiatrists who accept medi-cal are not likely to prescribe scheduled IIs. I could be wrong though.

When you see a psychiatrist accepting medi-cal is it free or is there a co-payment? It's worth a shot of its cheap.

BlackWarrior
08-06-17, 02:27 AM
When you see a psychiatrist accepting medi-cal is it free or is there a co-payment? It's worth a shot of its cheap. I recently enrolled in medi-cal because I'm going back to professional school so I don't really have an answer to your questions. I pay out of pocket for both my psychiatrist visit and refill.

sarahsweets
08-06-17, 06:28 AM
Have you tried the other medications and this is why you want adderall? Or were you on it before and you want to continue it?