i can't get my ambien because medicare doesn allow it anymore...a

Discussion in 'Fibromyalgia Main Forum' started by 69mach1, Feb 24, 2006.

  1. 69mach1

    69mach1 New Member

    i am screwed...bendryl i have to take 50mgs. if i can get anysort of sleep at all..then i am up and down up and down..theni am groggy and not thinking because of it...

    they told me they will not medicare will not pay allow and benzdiene meds...and that includs kolonopin..

    so basically i guess if i can get my pcp to prescribe mirapex i might be in lucki...
    they said it is on the formulary crap...
    i guess i should change my name to sleepless in novato


  2. 69mach1

    69mach1 New Member

    i have kaiser but i am on the senior advantage plan...and they go by the drug plan d thing...and theysaid this is something the federal govt.. did when they came up with this drug plan d for everyone on medicare

    and my medical won't pick it up either because of the drug plan d govt thing...pharmacist said it was a benzodiene so they don't allow that anymore for medicare...that i s my understanding...i had to go to the membership office tonight and talk to them about it...

    the pharmacist tech called someone and said they don't have in the system...so i have to go back on monday talk to kaiser ...even though have me in the membership plan but irregardless the drug plan d thing and the govt over rides everything form what we all were told..

  3. 69mach1

    69mach1 New Member

    i guess i will be more than usual exhausted...i have taken benedryl in the past and after a while it made me so wired i couldn't sleep...

  4. 69mach1

    69mach1 New Member

    they said they are not available in my area...then i called blue cross they are supposed to be sending me info on that...then i have to get ahold of my caseworker about the state picking up the tab on the monthly premium...this just stinks...

    so i hope have been misinformed but not likely.....

    i thought maybe i would be better just doing the medi/medi and the fill out one of those forms for free meds to get what i need since the fed govt doesn't allow this for us human beings...i swear it would be better to an animal...

    we could get put to sleep when we have something severe and don't have to deal with the pain anymore....

  5. 69mach1

    69mach1 New Member

    is? i just opened up some letter from humana stating the same thing i just wrote above...medi-cal won't pick up any drugs that med-care wont approve...

    what the hell good is my medi-cal then...i still have to pay the same co-=pay when i see the psychologist,the psychiatrist or the group meetings because they don't have a medi-cal contract....no wonder people stay on ssdi/ssi they can not afford the dr's visit then we have the co-pays now with medi-cal..yes they are still minimal compared to other people's co-pays, but at least they can get the medication tha they need that works...

    here i was starting feel like i could get somewhere in life again...after being cheated on and going thru a long divorce...

    i think i finally have an antidepressant that isn't makeing me gain a ton of weight like all pof the others...i have acutally lost 15 lbs in a month..not really trying hard trust me...i just went to the ymca two times in less than 5 days...this is a huge accomplishment for me...

    i feel like if i can not get some sleep i wil not be able to function at all...

  6. Roseblossom

    Roseblossom Member

    Try 5-HTP. It's an over-the-counter supplement that gives me sweeter sleep than any prescription meds I've ever tried.


  7. 69mach1

    69mach1 New Member

    i don't know what i will do...plus i am on antidepressants and your supposed to be careful the the 5thp

    thanks anywyas
  8. rockyjs

    rockyjs Member

    Thanks for informing us...I don't take any of the excluded drugs but am glad to know about the change in coverage. I read that there are two ways to reverse it. One would be by an act of Congress and there was a bill submitted last fall but I don't know what has happened to it.

    The other would be the head of Health and Human Services reversing the decision. So I guess we all need to get busy writing or calling our congressmen to try to change this. In my drug coverage plan it's considered a brand name drug, so it's still very expensive even with the plan, but at least I would get some coverage if I needed Ambien or similar drugs.

  9. sarahann61

    sarahann61 New Member

    And , I know how you feel, I took Ambein for about 3 yrs., and it cost me $55.00 with insurance.. That was just my co-pay.. I quit taking it over a mth. ago. because I was getting so forgetful.....

    I cannot take Benadryl, because of my breathing problems, and it does dry up all, secretions, even urine..

    I think Dramamine is better, and not as many side affects. It is anti-motion sickness tablets, and it is also an anti -nausea med., and you can buy it OTC, like benadryl.....................

    None of them, are good to take ,nightly.. But, I do know ,that you can't function, with out sleep..

    It is a dilemma, hope you can find what works for you, soon..........................
  10. 69mach1

    69mach1 New Member

    sorry if i forgot your user name...i am on the verge of crying here....

    i will take some benedryl...this is just not right to me...no benzo for anyone on medicare this is insane....

    yes i will be looking this up on the web too see what i can read and find out...

    i know my pharmacst is very savvy...so i like to think she nows what she is talking about...

    and if this is really true like these thre woman told me then i am going to have to write the congressman....

  11. 69mach1

    69mach1 New Member

    for the tip on dramaine

  12. granny1353

    granny1353 New Member

    and I ran out, so my husband bought over the counter sleep med. at walmart called wal som. Suppose to take one at bedtime, did that last night didn't fall asleep for 4 hours, so tonight I am going to take one a gew hours before bedtime and then one at bedtime. Hope it works. I will try to let you know tomorrow.

    I know I would panic if I could not get my ambien, I feel for you

  13. 69mach1

    69mach1 New Member

    are yo getting yours covered through medicare?

    i just read up o it and like the pharmacist said and rockjs said in a reply to me that medicare cut that out because it is potentionally addictive drug...

    yes i am addicted to sleep if i can get some.....sleep that is

  14. 69mach1

    69mach1 New Member

    in our great state of california they say if medicare won't pa y for it then medi-cal wont....

    and i got a new broschure in the mail today about this situation...not the benzos but if not covered in my state then medi-cal or medi-caid wont cover it...

    and the pharmacist that klonopin is not covered on the medicare formulary so medi-cal won;t cover it...

    oh boy

    how are you feeling rain? is life a little better now?

    you r friend

  15. Bambi

    Bambi New Member

    like they can for insurance when you need a medication the insurance doesn't want to pay for? I know nothing about the plan d thing except that some people are saying they are
    paying MORE for their meds in the long run and sometimes in the short term. I wonder if writing to the company that makes it would get it for you. Here we have to sign for it but it's not prescription yet so they don't pay for it on the insurance. IS it prescription there??

    It was supposed to stop the whackos from making meth with it. I have NEVER had it make me sleepy or anything but work for my sinuses. It does make my daughter sleepy..the antihystamines sp? in it. I only use
    it because my PCP said it wouldn't interfere with my asthma med and it hasn't. I've never found another sinus med that worked though. Things are getting ridiculous!
  16. cinnveet

    cinnveet New Member

    I went to get my Ambien filled in January and i was told as of the new year there is a list of sleep med's that are not covered UNLESS the Dr. calls the health care plan. So my pharmist called my Dr. and explained and gave him the phone no. to Atena. He called and now I am covered. So Please check with your pharmisist. I use Walgreens and they seem to be up on all the new changes with the prescribe sleep med's. Dont talk to just the cashier as they know nothing ask to speak with the pharmasist.
    I hope it works. Let me know if it does!
  17. 69mach1

    69mach1 New Member

    not up to my hmo kiaser this is medicare has the say so here for me...

    and in some states not california our medi-cal/and or medi-caid
    can pick up the tab if it is on it's own fomulary...but not for people on medicare here in my state...

    jodie[This Message was Edited on 02/24/2006]
  18. 69mach1

    69mach1 New Member

    thanks for checking...i edited my last response...i think i'm tired of being tired..like we all are...then have to fight for everything in life...yikes..

    sorry to hear about mr. not so wonderful....depleting your savings...just isn't fair....can you file a civil lawsuit against him for a false report to recoup or attorney fees and lost wages?

    again this just isn't fair.....

    i hope your eyes are healing much better.....

    how is the physical therapy doing for the baby to be? more like your body holding up?

    well i do think of you...you are a bright woman there has to be a pot of gold at the end of the (rain)bow right?

    you take care of yourself...


    i don't think there are any typos this time...
  19. marw

    marw New Member

    Hi Jodie,

    Do you have a Supplementary plan to go with your Medicare? I am on Medicare, too, but I have a Supplementary Plan with Blue Cross that pays for the drugs that are not covered by Medicare. That way you can still get the benzodiazapines. I would be ruined if I could not get them....they are just about all I can take. And I need the Ativan for Anxiety.

    I, too, have been trying Benadryl and it leaves me soo groggy if I take enough to sleep. I haven't tried Ambien. Maybe I should ask me doc for that. Sleeping is a real problem for me.

    I am very upset with Medicare's changes, too, for antoher reason. I lost my PT!!! How could they do this? Physical THerapy is the backbone of my existence! I don't know what I am going to do without it!

    I am so angry about the whole thing....all those changes that don't really seem to be helping many people...unless they are, and I just don't know.

    I hope you can get the policy with Blue Cross. I have it because I am a retired teacher, and it was part of our Pension Plan, but I think they have one for the public too.

    I hope you find something. How did you like the Ambien when you were taking it?

    Thanks, and good luck to you.
  20. rachel432

    rachel432 New Member

    i know ambien worked for you but if your going to be paying out of pocket for sleep meds you mey want to try one of the less expensive ones. i checked walgreens web site and found out generic valium(diazepam) 5mg tablets for 60 is $12.99, generic xanax(alprazolam) 0.5mg tablets for 60 is $16.99, and generic restoril(temezepam) 15mg capsules for 30 is $14.99. all of those are less then the price of ambien and maybe one of them would work for you. i hope this helps.

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