https://boards.hellobee.com/ Pregnancy, Baby and Parenting blog, by Hellobee en Mon, 13 Jul 2026 21:31:18 +0000 https://boards.hellobee.com/topic/insurance-wont-cover-zofran/page/2#post-1919854 Tue, 28 Oct 2014 16:27:47 +0000 erinpye 1919854@https://boards.hellobee.com/ <p>@macintosh: switch doctors. You need to have someone who takes you seriously. If you have HG, which since you're still really sick, it's likely, nothing, I mean nothing, else will work. Not ginger, not saltines, not unisom, not acupuncture, nothing. Zofran will only help a little, but it's something. I got my 8 mg odansetron Rx 2 hours after the script was written. They *can* get it to you faster, and staying on top of this will affect how well you manage for your whole pregnancy. I have a link to an HG support group on FB that helped me immensely- want it? Just wall me if you do, and hang in there :heart: </p> https://boards.hellobee.com/topic/insurance-wont-cover-zofran/page/2#post-1919261 Tue, 28 Oct 2014 12:08:29 +0000 Anagram 1919261@https://boards.hellobee.com/ <p>@macintosh: "should" be feeling better is total BS. Morning sickness doesn't follow any kind of specific timeline. Some people don't even get it until the 2nd tri, other have it their whole pregnancy. Mine didn't even remotely start lessening until 17 weeks and then was totally gone by 22 weeks. </p> https://boards.hellobee.com/topic/insurance-wont-cover-zofran/page/2#post-1919251 Tue, 28 Oct 2014 12:02:44 +0000 Mrs.Panda 1919251@https://boards.hellobee.com/ <p>@macintosh: Yeah at this rate I would switch to the OB. Nothing against midwives, but this particular one seems to not be as in tune to your needs or maybe she is too afraid of compromising her license. Make the call to see when they could get you in just so you have another option. </p> https://boards.hellobee.com/topic/insurance-wont-cover-zofran/page/2#post-1919199 Tue, 28 Oct 2014 11:42:55 +0000 macintosh 1919199@https://boards.hellobee.com/ <p>@ShootingStar: you know I've been seriously considering switching to an OB practice at the nearby hospital. I'm not medical professional either, but I'm intelligent and I educate myself and I don't like to be talked down to. </p> https://boards.hellobee.com/topic/insurance-wont-cover-zofran/page/2#post-1919120 Tue, 28 Oct 2014 11:13:57 +0000 ShootingStar 1919120@https://boards.hellobee.com/ <p>@macintosh: Maybe you need to see a different midwife? It's all well and good to say you "should" be feeling better. But for many women the nausea lasts well into the 2nd trimester. I know that and I'm not a medical professional :bummed: . </p> https://boards.hellobee.com/topic/insurance-wont-cover-zofran/page/2#post-1919110 Tue, 28 Oct 2014 11:10:31 +0000 macintosh 1919110@https://boards.hellobee.com/ <p>I'm 12 weeks. As the midwife pointed out I should be feeling better by now, but I'm not. In fact I just threw up my breakfast, when normally only throw up at night. I was only taking 4 mg of Zofran 2-3x a day and that was enough to keep me from vomiting. </p> https://boards.hellobee.com/topic/insurance-wont-cover-zofran/page/2#post-1919096 Tue, 28 Oct 2014 11:05:11 +0000 Mrs.Panda 1919096@https://boards.hellobee.com/ <p>@macintosh: :( I'm sorry. It's just so limiting what can be done, especially in early pregnancy. I hope your Zofran situation gets sorted out but be careful with the amount you are taking. How far along are you again? </p> https://boards.hellobee.com/topic/insurance-wont-cover-zofran/page/2#post-1919084 Tue, 28 Oct 2014 11:00:05 +0000 macintosh 1919084@https://boards.hellobee.com/ <p>@Mrs.Panda: I'm actually on diclegis too. I had been taking it only at night, but since I've run out of Zofran I'm taking it during the day too. I doesn't seem to do anything but makes sleepy and the past 2 nights I woke up nauseated at 3-4 am. </p> https://boards.hellobee.com/topic/insurance-wont-cover-zofran/page/2#post-1919023 Tue, 28 Oct 2014 10:32:56 +0000 Mrs.Panda 1919023@https://boards.hellobee.com/ <p>@macintosh: Yeah it's actually debatable in some circles, it's technically a Cat B but some research has shown that maybe it should be put into Cat C because of some findings related to cardiac issues in newborns, but they haven't been able to establish a strong cause-and-effect link between the two. Have you tried Diclegis? It's really just an antihistamine and B-6, so essentially benadryl and B-6. And that stinks they didn't get the form! Ugh, I'm sorry you're going through this. </p> https://boards.hellobee.com/topic/insurance-wont-cover-zofran/page/2#post-1919018 Tue, 28 Oct 2014 10:30:03 +0000 Rockies11 1919018@https://boards.hellobee.com/ <p>@macintosh: I can't believe they're saying that it's category C! </p> https://boards.hellobee.com/topic/insurance-wont-cover-zofran/page/2#post-1919014 Tue, 28 Oct 2014 10:25:24 +0000 macintosh 1919014@https://boards.hellobee.com/ <p>@Mrs.Panda: the midwives keep saying Zofran is category C so they don't like to prescribe it. When I looked it up its category B! Ugh. </p> <p>@78h2o: I wish! I found out the midwife never received the form from the insurance company so I had to call BCBSIL again to ask them to fax the form!</p> <p>I checked prices at Walgreens vs. Target for 10 4mg oral tabs. Walgreens - $55, Target - $15! So I asked the midwife to call in a new script but they don't come in til the afternoon :( </p> https://boards.hellobee.com/topic/insurance-wont-cover-zofran/page/2#post-1918893 Tue, 28 Oct 2014 09:35:40 +0000 78h2o 1918893@https://boards.hellobee.com/ <p>@macintosh: we have BCBS federal...don't know if the company makes a difference, but when my husband needs pre-auths for his meds, they often can get them the same day or next, as long as its early in the day and a business day, not weekend. Good luck. </p> https://boards.hellobee.com/topic/insurance-wont-cover-zofran/page/2#post-1918531 Mon, 27 Oct 2014 21:48:33 +0000 Mrs.Panda 1918531@https://boards.hellobee.com/ <p>@macintosh: well the only thing with Zofran is that it can be kind of hard on the kidneys, especially in women, when taken over a period of time. The liver as well but slightly less so, so I understand why your midwife is cautious with prescribing it. But you're right, the risk of dehydration is real too. Unisom may be a good option in the meantime as it can reduce nausea as well! </p> https://boards.hellobee.com/topic/insurance-wont-cover-zofran/page/2#post-1918521 Mon, 27 Oct 2014 21:35:16 +0000 macintosh 1918521@https://boards.hellobee.com/ <p>@Mrs.Panda: Even more interesting! Do you think it's a red flag that my Midwife practice didn't seem to be aware of this process? I can't tell if she just didn't really want me to take the Zofran (tried to talk me into more "natural" remedies again) or if she just didn't know. I'm tempted to switch to an OB, but I feel like I should give the midwife thing a chance.</p> <p>I'll definitely be calling the insurance company as well as the midwife practice to follow up tomorrow! </p> https://boards.hellobee.com/topic/insurance-wont-cover-zofran/page/2#post-1918497 Mon, 27 Oct 2014 21:23:04 +0000 Mrs.Panda 1918497@https://boards.hellobee.com/ <p>@macintosh: hmm maybe because I worked in mental health they were a little more quick with their turn around... but doubtful because insurance is insurance! I remember going ape shit with a clinical review specialist (NOT a nurse) on the phone because he wouldn't approve a medication for someone with suicidal and homicide ideations. I had to go to their supervisor but I eventually got it approved. Crazy to me that they have non clinical people approving or denying medicine! </p> https://boards.hellobee.com/topic/insurance-wont-cover-zofran/page/2#post-1918492 Mon, 27 Oct 2014 21:19:06 +0000 MamaG 1918492@https://boards.hellobee.com/ <p>I can see where the self dissolving would be more expensive. I would also seriously consider a higher dosage and splitting them. My DH has to split some meds that he's on and it's not hard. I did it when I weaned off the zofran. I'd try just a half dose and if it was enough then good, if not I'd still have the other half ready. </p> https://boards.hellobee.com/topic/insurance-wont-cover-zofran#post-1918491 Mon, 27 Oct 2014 21:18:56 +0000 macintosh 1918491@https://boards.hellobee.com/ <p>@Mrs.Panda: Interesting. My insurance said if they mark it urgent it still takes 72 hours, they said normal processing time is 7-10 business days. That's crazy! </p> https://boards.hellobee.com/topic/insurance-wont-cover-zofran#post-1918488 Mon, 27 Oct 2014 21:16:50 +0000 Mrs.Panda 1918488@https://boards.hellobee.com/ <p>@macintosh: yes to the prior authorization and your midwife can write "Stat" or "urgent" on it and they should process it within 24 hours. I used to do these all the time and rarely got fully denied. </p> https://boards.hellobee.com/topic/insurance-wont-cover-zofran#post-1918484 Mon, 27 Oct 2014 21:12:30 +0000 macintosh 1918484@https://boards.hellobee.com/ <p>Ok, so I called Target to get a price quote. Ondansetron 4 mg (dissolving) was quoted at $160+ for 30 tabs (a 2 week supply). Regular ondansetron 4mg would be $45 for 30 tabs. Hello, price difference! </p> <p>I almost threw up my dinner again tonight so tomorrow I'll call the midwife and see if she can get me a short term supply called in to Target.</p> <p>I've never had and issue like this with any of the 20 - 30 different scripts I've filled for myself or my DH over the past 2 years. Lame. </p> https://boards.hellobee.com/topic/insurance-wont-cover-zofran#post-1918381 Mon, 27 Oct 2014 20:15:23 +0000 Blueberry 1918381@https://boards.hellobee.com/ <p>I took one of the generic zofran (in the morning) and one promethazine at bedtime (because they knocked me out) for my morning sickness. It was very bad in the beginning.<br /> I really hope your insurance pulls through! I hate that you're feeling this way :( </p> https://boards.hellobee.com/topic/insurance-wont-cover-zofran#post-1918327 Mon, 27 Oct 2014 19:41:38 +0000 erinpye 1918327@https://boards.hellobee.com/ <p>Odansetron isn't expensive- have your doc call in the genetic. Even out of pocket it's not too bad, and worth it. </p> https://boards.hellobee.com/topic/insurance-wont-cover-zofran#post-1918291 Mon, 27 Oct 2014 19:11:39 +0000 Tanjowen 1918291@https://boards.hellobee.com/ <p>@macintosh: I know birth control isn't Zofran, but I was able to get a 6 month supply at a time of birth control from Walmart. It's the only place I know of that will do it that way! I would call their pharmacist and see what advice they give and how they need the midwife to write it up. My sister is a pharmacist and they love to dispense this kind of advice, trust me :) </p> https://boards.hellobee.com/topic/insurance-wont-cover-zofran#post-1918289 Mon, 27 Oct 2014 19:09:03 +0000 blackbird 1918289@https://boards.hellobee.com/ <p>$400 seems insane for generic, I would definitely follow up about it-mayne there's a different version or dose. And maybe a place like Target or Walmart or sams club sell it inexpensively. Prescriptions are priced competitively! </p> https://boards.hellobee.com/topic/insurance-wont-cover-zofran#post-1918282 Mon, 27 Oct 2014 19:03:27 +0000 Caly 1918282@https://boards.hellobee.com/ <p>@ScarletBegonia: hahaha I gave my extra to a friend of mine who was dying of nausea, you do what you gotta do! </p> https://boards.hellobee.com/topic/insurance-wont-cover-zofran#post-1918278 Mon, 27 Oct 2014 19:00:59 +0000 Caly 1918278@https://boards.hellobee.com/ <p>@MamaG: I agree, having a higher dose prescribed is definitely worth the try. My dr prescribed me a higher dose simply so I could cut them in half since he said some patients have issues with insurance covering zofran. </p> https://boards.hellobee.com/topic/insurance-wont-cover-zofran#post-1918273 Mon, 27 Oct 2014 18:56:58 +0000 jhd 1918273@https://boards.hellobee.com/ <p>I didn't read the previous posts so sorry if I'm repeating something others have suggested. My OB was able to call in a prescription for a higher dose &amp; then I just cut the pills in half. Like you I needed more per month than the measly amount my insurance covered! I hope you can get more Zofran and hope even more that the sickness goes away soon!</p> <p>ETA my OB also gave me a prescription for promethazine which she told me to take at night in case it made me sleepy. It didn't. Between that and the different dose of Zofran I had enough to get me through the worst of the sickness </p> https://boards.hellobee.com/topic/insurance-wont-cover-zofran#post-1918252 Mon, 27 Oct 2014 18:38:44 +0000 ScarletBegonia 1918252@https://boards.hellobee.com/ <p>When I burned through the 4 (!!!!!!!) pills my doctor gave me in 2 days, I put out a call on facebook to a mom's group I was part of, to ask if anyone had any leftover zofran from their pregnancies (cost wasn't the issue for me - universal healthcare for the win - it was my doctor that didn't think i needed it), and I got a massive response! It may not be safe, ethical or right, but damn did I jump on those offers - made my husband drive 20 minutes to the suburbs to pick up 14 pills from a woman who didn't need them anymore. You do what you have to do. Good luck with the insurance, though, I hope they start covering more for you. </p> https://boards.hellobee.com/topic/insurance-wont-cover-zofran#post-1918244 Mon, 27 Oct 2014 18:32:26 +0000 Anagram 1918244@https://boards.hellobee.com/ <p>@macintosh: My insurance would only cover a 2 week supply each month (I know, makes no sense) so I paid outof pocket for the 2 two weeks. But I was on Ondansetron (generic) and it wasn't expensive at all out of pocket. Maybe $30 for a 2 week supply? It was 100% worth it for me.</p> <p>And I *never* rationed out the pills, because I felt way more shitty. I even took an overnight dose so I didn't wake up barfing. </p> https://boards.hellobee.com/topic/insurance-wont-cover-zofran#post-1918211 Mon, 27 Oct 2014 17:56:08 +0000 Little Misters Mom 1918211@https://boards.hellobee.com/ <p>Unisom (and regular kind, not the slow release) and vitamin B6 taken together. It's not quite as good as zofran but it's very close and will give you a little relief until you can sort this out. I am always skeptical of the OTC being as good but this really did help and is the same active ingredients as the prescription Diclegis. Does your doctor or midwife practice have any sample packs of zofran they can give to you to tide you over?</p> <p>Call insurance and ask what precisely the one month rule is. For mine it was one month supply, not 30 pills. So the doctor could call in basically any amount (or any amount that theoretically could be taken in one month) but I was only able to fill one prescription in a 30 day period. </p> https://boards.hellobee.com/topic/insurance-wont-cover-zofran#post-1918196 Mon, 27 Oct 2014 17:39:04 +0000 yoursilverlining 1918196@https://boards.hellobee.com/ <p>@Boheme: that sounds familiar (phenergan)! </p>