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Dr. Finally Prescribed Nuvigil...will Insurance Approve It?

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My dr. finally prescribed Nuvigil. I took it to the pharmacy on Friday. They were going to try and get the prior authorization done. How long will it take to find out something? They really didn't give me any answers, other than we will get the process started. I am keeping my fingers crossed that insurance will approve it!  

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It really just depends on your insurance company and policy.

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That really depends on your insurance. I saw my doc on Tuesday. They faxed the PA paperwork in that day. I took my script for Nuvigil to the pharmacy on Friday, and it still wasn't finished. Guess I get to call in the morning to follow up with Expresscripts to make sure the PA is done. One would think that since it will cut my script down from 2 Provigil pills a day to just one they would be all over it. I don't know exactly how much the Nuvigil will cost the Navy, but it can't be more than 60 Provigil pills a month. That stuff is outrageous.

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I am still going through the saga of getting approval for Nuvigil. I called twice today and was told that my prior authorization was approved, but when I went to the pharmacy it was denied. They called to find out exactly what was going on, and it turns out that, as an active duty member, I needed a medical necessity form filed from the doctor as well. This really pisses me off. 

 

400mg Provigil per day $1600 per month cost to the DOD.

 

250mg Nuvigil per day $500 per month cost to the DOD.

 

I have to jump through all of these hoops, and bend over backwards to get approval for Nuvigil when it will save the government $13,200 a year. All because someone decided Provigil was formulary, and Nuvigil was not.

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Thanks for your help..I have Blue Cross Blue Shield of SC. I did have one of the cards from the maker of Nuvigil that would make the 1st month no more than $50, so hopefully the insurance will realize that will save them some money. The dr. gave me a sample pack of Provigil to take for now, but it really doesnt help me like the Nuvigil. He said he does not like to prescribe Adderall, because they are so addictive. So I really hope the insurance approves it :)

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My prescription insurance is through ExpressScripts. Doc's office told me they'd call the prescription in to my pharmacy, but it might take "a few days" if they had to file a prior authorization. So, I waited three days, then went to the pharmacy, and they had it ready when I got there.

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Unfortunately I still have not heard anything, I called the pharmacy Tuesday and they said it had not been approved yet. Tomorrow will be 1 week!  I am going to call my dr. tomorrow and see if they can check on it and get things moving. He gave me samples of Provigil, but they do not work anywhere near like Nuvigil. 

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I finally got my meds! I can't wait to see how I feel taking them on a daily basis!

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I finally got my meds! I can't wait to see how I feel taking them on a daily basis!

 

I understand the relief of finally getting them. I had to wait for the prior authorization, and then they figured out that I needed a "medical necessity" authorization to authorize the non-generic. What a pain in the butt. The Nuvigil is definitely working much better than the Provigil, and costs the government $1200 less a month. The pharmaceutical companies are such thieves. 

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Glad to hear you both finally got through the paperwork!

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It took me like a month the first time. Those prior auths are crazy.

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Went back to the dr today and I told him I thought the Nuvigil was losing its effectiveness :( so  he gave me a higher dosage to try..I hope I dont have to go the pre auth again. He suggested I try cutting it in half and taking one early and the other around 11..Keeping my fingers crossed that this will work.

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Nuvigil wasn't covered so I just ordered generic provigil online where its cheaper anyways. If you're curious this is where I buy it without a prescription Superdrugsaver.com

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From my experience with insurance billing (I was not an insurance biller, but worked with billing) Blue Cross seemed to deny more claims than any other company.  Cigna approved mine on the spot without any complications.  Blue Cross denied mine, and it is a difficult process to get them to approve it.  If they do, be prepared to wait a few months, because I've seen paperwork drag out a good 6 months. If you get a chance to change, for you sake, I highly reccomend changing insurance companies.

Thanks for your help..I have Blue Cross Blue Shield of SC. I did have one of the cards from the maker of Nuvigil that would make the 1st month no more than $50, so hopefully the insurance will realize that will save them some money. The dr. gave me a sample pack of Provigil to take for now, but it really doesnt help me like the Nuvigil. He said he does not like to prescribe Adderall, because they are so addictive. So I really hope the insurance approves it :)

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