Fentanyl Patch And Insurance Refusal

My doctor changed my patch dose from every 72 to every 48 hours. 75 mcg dose. My insurance refused to allow it. I have AARP (united healthcare). For me it would have been much better as on the third day I get no relief....

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Hello, Aaron! How are you? I am very sorry about what happened.

Most insurances will not cover it being used every 2 days, instead of every 3, unless someone has intractable due to a possibly fatal condition such as stage 4 cancer. I know that isn't really helpful, or comforting, I am just stating the facts.

The FDA warns that this medication carries the risk of being habit forming and may cause side effects, such as nausea, dizziness, headache, constipation, and dry mouth.

Has your doctor made any other suggestions? They might be able to prescribe an additional medication to help.

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My doctor will probably raise me to 100mcg the next time I see him. That should cover my pain level for three days. I just started on the patch transitioning from oxycodone 30s, which were eating up my stomach.
It's funny but the insurance company let me change out every 48 hours at the lower doses as I titrated up to 75 mcg.
Then at 75 they would not allow it.
Thanks for your reply.
Oh and also they would not fill it if I also took a breakthrough med. I think that was the problem overall.

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I would call the insurance company. United told me they allowed up to 30 patches/mth. Yes30/mth!! May be the plan you are on?? Just call # on your card and talk to them. They may be able to over ride this block for you. Your Dr may need to contact them too. Good luck!!

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