View Full Version : Medicaid in NYS pay for Adderall?


jkimbo
08-07-17, 07:15 PM
I apologize if this has already been covered, I did try to search first. I been on adderall for about a year with nothing but positive results! I don't feel a buzz or high, it makes me feel normal! I can suddenly remember things, stay focus longer, finish tasks, work around the house, fix things, all these things that most people take for granted are a luxury for me and I value it greatly!

Anyway I lost my job and insurance July 6th. I have applied for medicaid and was approved. This time when it was time to get a new script for adderall I am suddenly waiting for "pre-approval" something I never had to do before. No one seems to know if Medicaid covers adderall here in NYS. I keep getting different answers and the run around. Call your doctor, call your pharmacist, call medicaid. Is there anyone here from NYS on Medicaid getting adderall? BTW, waiting for my klonopin too but not as worried about them because ever since I started adderall I need less and less klonopin.

I'm worried because I had a simple script filled, triamcinolone acetonide ointment filled and I use to get a big tube of it, but instead medicaid would only pay for a small tube. So if they were that picky over ointment, I'm worried they will not want to cover adderall because so many people have no clue how vital it is just to be normal.

Can any one shed some more light on this topic? Thanks.

ToneTone
08-07-17, 07:48 PM
I think this is a state-by-state thing.

Here's the link to New York's prescription Medicaid Program.

There are preferred drugs and non-preferred drugs. The non-preferred drugs appear to require special authorization.

If you go to page 15, you'll see the list of stimulants.

Here are the preferred stimulants, which I presume are easier to get without so much authorization hassle.

Adderall®
Adderall XR®
amphetamine salt combo IR
Daytrana®
dextroamphetamine (tablet)
Focalin® 1
Focalin XR®
Methylin®
methylphenidate (tablet)
Quillivant XR®
Vyvanse® (capsule)

The New York State pdf is here:
https://newyork.fhsc.com/downloads/providers/nyrx_pdp_pdl.pdf

Good luck.

Tone

jkimbo
08-09-17, 12:55 AM
Yes it is a state by state thing, some states have stricter guidelines. BTW those links were as clear as mud. Anyway good news, NYS medicaid will cover adderall (generic of course), but certain meds require a "pre-apporoval" form faxed to them from the doctor basically explaining why your on adderall and why you should stay on it. There are only a few (I think 3 sub-categories), I know for sure Benzos and Stimulants. I'm assuming opiades too as these three have been getting a lot of attention in the news.

So the next day I called the pharmacy and she tried again to process my orders and they went threw! But I only got a 10 day bridge script because my doctors appointment is coming up. I see him every 4 months.

I can't believe the run around I got! No one knew for sure. So if your in NYS and have to go to medicaid and you can't get your script as quickly as your use to getting it, the hold up is simply they are waiting for the doctor to fax over the pre-approved form. You might want to remind him about that the next time you see him too.