Why would insurance suddenly start to deny ppi

[tiredtwinmommy 30]

So I had my vsg surgery may 29, and have been on generic Prevacid ppi 30 mg daily for several years now. I have had refills this whole year with no issues until now. This is the first time I have needed a refill since surgery and they are denying me why now? Am I going to have to stretch my remaining stash out? Anyone else dealing with this?

[moonlitestarbrite 902]

call your insurance company and ask them.

[gomekast 559]

So I had my vsg surgery may 29, and have been on generic Prevacid ppi 30 mg daily for several years now. I have had refills this whole year with no issues until now. This is the first time I have needed a refill since surgery and they are denying me why now? Am I going to have to stretch my remaining stash out? Anyone else dealing with this?

My ins requires that any common maintenance med like that be written in a 90 day supply for the script. If it's written in 30 day form it won't get covered. 90 day scripts will.

Maybe it's something similar??

[tiredtwinmommy 30]

I am at dentist office with kids so I will call insurance when I get home. But that is a good point about 30 day I did not think to ask if they did the. 90 or 30. I will check that out too. Thanks for the suggestions and putting up w my mini vent

[RickM 1,752]

Another possibility is that they won't cover it if it is also available over the counter without prescription - many of the PPIs (like Prilosec/omeprazole) are in that situation. But if you are prescribed a dosage that's not available OTC, then it will go thru with the insurance coverage. Prilosec OTC is 20mg so that is often not covered by insurance, but if the doc prescribes the 40mg size, which is a prescription dosage, then it does get covered.