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Adderall refills...

Started by Apple, Jun 09, 2014, 09:55:45 AM

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Apple

I'm not sure there's anything that can be done about this, so this may be more of just a rant... 

YSD is on Adderall for ADHD.  As of last summer, the doctor instructed us to only give her the meds on school days.  He was concerned about her lack of weight gain.  BM was using her insurance to get the meds filled (even though DH's insurance is supposed to be primary).  Each refill was $5, so she didn't bother asking for the $2.50 from DH. 

Fast forward to last month.  DH decided to check YSD prescription records at CVS.  Turns out, BM had the Adderall refilled every month, even though they're prescribed for just school days (the doctor allowed a refill every month).  When we calculated school days vs. pills she's received she should have more than 30 extra.  When DH asked her about this she became defensive and seemed to over explain what happened (all of it was BS).

She emailed DH last week that she had to get the Adderall refilled and since she no longer has the same insurance, the bill is now $54 a month, and DH owes her $27 (uncovered medical is split 50/50).  DH is resisting paying her because she should not have needed the refill.  She did something with all the extra pills.  When confronted about where they went she claimed she's given us 20-25 extra (Dr said we can give them to YSD on weekends if social situation required it).  She's given us 6 extra since last summer, of which we still have 4.  We have emails with her where she clearly resists giving DH any extra pills when we asked for just a couple, it's pretty obvious she didn't give us 20-25. 

BM has a history of drug use and I would not put it past her to sell some of the pills.  Her husband currently has 2 judgments against him for about $25k, I'm sure they could use the money.  She is threatening to take DH to court on this issue.  I am so frustrated that she's getting away with this.  Of course she didn't collect on the previous refills, she didn't want us to know she was getting it refilled so much.  DH will be attending the next Dr appointment to understand why the Dr would allow the refill so often. 

MixedBag

FIRST fix the insurance situation since that's one you/Dad can probably handle without her cooperation.

Figure out -- by contacting the pharmacy -- the other insurance information and notify them that Dad has insurance and Dad is supposed to be primary.  They should "stop paying" until the primary insurance is filed.

Second, give the primary insurance information to the pharmacy and let them re-run the insurance claims.  In the last couple of years (considering I've been dealing with this stuff -- divorce -- for over 24 years now) Pharmacies have finally come up to speed to have two (maybe more) insurance companies in their system.  (Around here Rite Aid was the first to have it).  That will reduce or eliminate mom's witching about getting reimbursed from Dad.

You/Dad should be doing this on all fronts -- dental, medical, prescription, vision, mental -- whenever a parent asks for reimbursement, make sure that ALL insurances that are available have processed the claim, THEN follow the order of reimbursing the paying parent.

As for the number of pills -- not sure you can prove anything about that.  I also get the feeling that it's a tense situation -- and while I understand the concern about "where's that extra medication going?"  I'm thinking...and maybe others will disagree and that's ok, that this is not something a court will do anything about on a scale of 1-10 until the child is harmed.

The doctor should write the prescription correctly -- less days -- if that's how he verbally prescribed.

Fix the insurance and that will fix that problem.

Make a separate appointment to see the doctor -- so that Dad can truly speak freely about his concerns about the extra pills -- and then keep a very close eye on how her behavior affects the child.

MixedBag

I just sorta searched to see if and what you posted about before...

Notifying the other insurance company that there is other insurance available and that it's supposed to be primary, and sending a copy of the current order USUALLY takes it out of the non-cooperating parent's hands and forces them to do it the right way whether they want to or not.

Start by going directly to CVS with the prescription insurance information and ask them to rerun the claims against the child's perscriptions.  there's nothing Mom (or if this were a dad) can do about it.  And in this day and age, those insurance companies will pay attention.

Apple

Although I agree the insurance issue needs to be addressed, we're more concerned about the 30 some pills that are unaccounted for.  We have no proof that she did anything with them, but she sure was defensive about it. 

BM does not use DH insurance for the meds because they don't cover the meds at all.  In general she'll use the policy that has the lowest out of pocket.  Since DH's insurance is primary, BM has to run it through DH's first, if we try and run it later, they won't process it since the primary was not used first.  Yep, it's a mess. 

DH will pay her, since he didn't pay for any of the refills when they were $5, and he will attend the next doctor appointment (BM was recently directed by PC to give DH 7 days notice on appointments so he can attend).  I believe it's irresponsible for a doctor to overprescribe a medication known for abuse. 

Mom1Step2

While it is illegal to sell or use the pills herself, it isnt nessesarily harming the child. You would have to prove harm in court for custody reasons. The issue of her using/selling the pills, you would have to get her busted some way and it would have to be legal. Like have her sell some to a cop or something. Probably not going to happen. Sometimes you just have to let things go and let them get themselves in trouble.

Apple

I agree, there's nothing we can do at this point.  My guess is, her knowing we're on to her may stop the behavior.

ocean

I agree, fix the insurance and you owe the 50/50 regardless of extra pills each month. Our pharmacies here will only process one insurance, so it can be a pain if one does not cover it. My daughter is on ADD pills and on weekends, depending on what we are doing, she may take it. The dr has it written for 30 days, in case she needs them. We just wait an extra week to order the next bottle. You can ask the dr for a med that is covered under both insurances.

Maybe call the dr before hand and tell them your concerns and if there is no reason to have them on weekends, then to please prescribe 20 school days worth. You really can not control what she does with them. If there is a real concern that you can prove, you can ask that child be given meds at school first thing in AM (with doctors note that can be done). Very hard to prove she is taking extra pills or even giving her all her pills.



Apple

Our pharmacy will only run one insurance too...


MixedBag

It's a "new thing" that pharmacies can run two.

You might want to ask the question again -- Rite Aid also only ran one insurance and then they upgraded their software to run two.