Child Health Plus (BCBS) no longer covering Ritalin.

My daughter takes Ritalin. She is on NY's Child health plus. Picked up my script for her and went to get it filled at Walmart. Now they don't cover it anymore. We could go to the generic, but they don't have a time release version and the other stuff didn't work for her. Is this how they are saving money? No longer covering something like ritalin? It just get's very depressing. Every time I feel like we are doing ok something kicks us in the teeth. I mean, we already got kicked off the Family Health Plus and our two younger daughters got kicked off medicaid. Now this.

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3 replies	Author	Time	Post
Child Health Plus (BCBS) no longer covering Ritalin. (Original post)	ejpoeta	Jan 2012	OP
Your doctor should write them and explain	Ilsa	Jan 2012	#1
turns out there is a generic. I misunderstood the lady.	ejpoeta	Jan 2012	#2
Try it and see how it works for her.	Ilsa	Jan 2012	#3

Response to ejpoeta (Original post)

Tue Jan 24, 2012, 07:53 PM

Ilsa (31,695 posts)

1. Your doctor should write them and explain

Why she needs the Ritalin, and that changing to a different ER drug is unnecessary experimenting. They don't all work the same, and some have side effects that the Ritalin may not have on her. (we had to try different drugs for my son.)

The good news is that if there is enough medical backlash, they might change their minds. United Healthcare tried to dictate the dosages of Seroquel a couple of years ago (said kids had to take a minimum of 100mg per dose), but they backed down from practicing medicine.

Good luck!

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Response to Ilsa (Reply #1)

Tue Jan 24, 2012, 08:06 PM

ejpoeta (8,693 posts)

2. turns out there is a generic. I misunderstood the lady.

They are backordered and can't get it anywhere. And BCBS said they will no longer cover the name brand ritalin at all... so they will only cover the generic even if it is backordered and you can't get it anywhere.

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Response to ejpoeta (Reply #2)

Wed Jan 25, 2012, 07:11 AM

Ilsa (31,695 posts)

3. Try it and see how it works for her.

Document everything about her performance and side effects with the drug change. Sometimes even the generic is slightly different and might not work as well for her.

Good luck.

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