Posted By Posting
Nov 11, 2011
kavyamom
How is your insurance coverage for Zegerid powder?
I normally pay $10 for generic and $20 for brand. However, for this Zegerid powder they are charging me $40 since it is not their preferred drug (they consider it tier 3 brand). Just wondering how your insurance coverage for this is?
Nov 11, 2011
vigilantmom
Ryan was born May 20th 2008. 9 lbs 2 oz. Ryan’s magic bullet was 30mg of Prevacid capsules mixed with Caracream from Marci-kids (I am forever indebted to the team at Marci-kids), Claratin for the mucos, and Mirlax for the constipation. Within 2 months of this combo he jumped from the 6% to the 50% for weight and continues to climb. Be strong, listen to your instincts. Read his story for more specifics that just might help you too - Karen
With most carriers, if your doc writes a note that they have tried all the lowered Tiered drugs with poor results they will cover the Tier 3 at the cost of Tier 1.
Nov 11, 2011
kavyamom
That's what I thought and I asked the insurance about it this morning. The agent said that a letter from the doc would be of no use. Anyway, the insurance is never on our side so I will at least ask my doc to write and see what happens. Well, actually first I will see if Zegerid even works for her (prilosec in the past didn't seem to suit her).
Nov 12, 2011
jeddsmommy
Jessica, Mommy to Jedd, severe reflux, severe food and oral aversions, Finally G tube free!!! VSD repair 4-24-07 (open heart surgery), hypospadias, repaired 3 times and Ear tubes Visit Jedd at his CB site: www.caringbridge.org/visit/jedd
Well, for us, Prevacid Solutabs were tier 1 on one plan and tier 3 on another!! I about had a heart attack when they told me one month was $60.00!!! Each ins co can decide on it's own where each drug lies. there is NO industry standard.

Our GI told us he has had ZERO success in getting the ins co to change their minds even if he writes a letter. And he is a very reasonable man, we love him dearly as we have been through ALOT with him in our care for our son.

I am getting ready to see if either Zergrid or Prilosec powder will be covered cheaper, if not, we will have to continue to pay through the nose......

Check with your
doctor first!