Healthcare / Insurance fish - I need help. My insurance only covers the generic form of my prescription drug. The generic is out and there is a nationwide shortage of the generic. Is there anything I can do to get my insurer to cover the brand name drug? Express Scripts is my Rx insurer

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Have you tried GoodRx?

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Yes. Still expensive

Sometimes if you call your insurance and explain the situation, you can get an exemption and get the brand name covered. This happened to me with an epi pen recently

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Also check the manufacturer’s site for any coupons.

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There should be language about covering the brand if generic is not available in your benefits documentation. In most cases they should cover.

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I had that problem with one of my son's medications. He takes a 20 mg dose and no pharmacy in our area had it and couldn't order it. I found out there was a 10 mg generic as well so I had his doctor rewrite the script for twice the amount of the 10 mg.

So check with your doctor if there is a lower dose available that you could double up on, or even if there is a higher dose that you could use a pill splitter on.

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Thank you

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