Home Forums General Discussion How to appeal insurance for brand minocin

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  • #308841
    Airen
    Participant

    I put in a special request for brand minocin and it was denied. Isn’t there something specific the generic has to do to you before they will allow the brand? I want to appeal but don’t know how.

    Thanks!

    Diagnosed with RA in October 2014, pain started in February 2014
    Started AP in June 2015
    Taking daily: 32.5 mg WP thyroid 6 am, 100 mg mino 9 am, 16.25 mg WP thyroid 2 pm, B Complex for MTHFR mutation 3 pm, Multivitamin 3pm, 100 bil powdered probiotics 6 pm, 5-8,000 iu Vit D 6 pm, 100 mg mino 9 pm

    #375541
    richie
    Participant

    Is your doctor on board with your request ! Did he help in any way .
    Richie

    #375542
    Airen
    Participant

    Yes she already put in one request for me stating the generic made me nauseous. It was denied. I would like to appeal but I thought maybe there were certain criteria that they looked for to approve the brand. Such as gerd. Phil what would this forum do without you? You seem to be the only one to answer everyone’s posts! ??

    Diagnosed with RA in October 2014, pain started in February 2014
    Started AP in June 2015
    Taking daily: 32.5 mg WP thyroid 6 am, 100 mg mino 9 am, 16.25 mg WP thyroid 2 pm, B Complex for MTHFR mutation 3 pm, Multivitamin 3pm, 100 bil powdered probiotics 6 pm, 5-8,000 iu Vit D 6 pm, 100 mg mino 9 pm

    #375543
    jasregadoo
    Moderator

    Airen, that’s Richie not Phil. They are both very helpful, as are all of the other volunteers here. 🙂

    I believe Richie is your go-to guy here, as he is on Minocin (brand name) and has been successful in getting it through his insurance. Phil is on a generic, I think, though it works well for him.

    Most of us, I suspect, are on generic, due to the crazy pricing of brand name and difficulty in getting the insurance companies to pay for it.

    #375544
    Airen
    Participant

    Ugh! So sorry Richie! Thanks so much for all your helpful replies!!

    Diagnosed with RA in October 2014, pain started in February 2014
    Started AP in June 2015
    Taking daily: 32.5 mg WP thyroid 6 am, 100 mg mino 9 am, 16.25 mg WP thyroid 2 pm, B Complex for MTHFR mutation 3 pm, Multivitamin 3pm, 100 bil powdered probiotics 6 pm, 5-8,000 iu Vit D 6 pm, 100 mg mino 9 pm

    #375545
    jasregadoo
    Moderator

    I just saw this article online, and thought of this post. I don’t know if it’s helpful or not, but there is some guidance on appealing your insurance decision. Also, advice is to ask at your pharmacy what the price would be with no insurance. The answer might not be acceptable, but it might surprise you and be lower.

    http://ww2.kqed.org/stateofhealth/2015/09/15/how-to-save-money-on-prescription-drugs-whether-youre-insured-or-not/

    #375546
    PhilC
    Participant

    Hi Airen,
    @Airen wrote:

    Yes she already put in one request for me stating the generic made me nauseous.

    Minocin might help with that, but if you’re hoping that it will help with your other (Herxheimer) symptoms, I think it’s likely you’ll be disappointed. Looking at some of your other messages, it seems that you may be sensitive to minocycline. Either that, or it’s working a little too well for you. If I am right, then there are at least a couple of possible solutions — lower your dose of minocycline, or switch to doxycycline. Doxycycline tends to be much easier to tolerate than minocycline, especially for people who are in the early part of their treatment. I started on doxycycline first, and it never made my joints ache. I’ve been almost 100% free of pain for many years, so that was probably part of it. Minocycline, on the other hand, did make my joints ache.

    There’s a pelleted from of doxycycline called Doryx. Unfortunately, like Minocin, Doryx is also very expensive, so it is unlikely that your insurance would cover it. However, if your doctor writes for you a prescription for Doryx with substitution allowed, then the pharmacy can fill your prescription with generic, pelleted doxycycline. Although pelleted doxy is more expensive than the regular kind, there’s a good chance that your insurance would cover it since you would be getting a generic instead of genuine Doryx.

    Phil

    "Unthinking respect for authority is the greatest enemy of truth."
    - Albert Einstein

    #375547
    Airen
    Participant

    I am not really having any adverse affects from the minocycline. I just WANT the brand in hopes that it will work better. I have not given the current generic enough time really…so it may be working just fine. I’ve only been on it 2 months now. I am just being impatient and looking for a way to get the brand. I contacted my insurance company and my company apparently has a generic only policy. So there is no appealing for the brand unfortunately. If there is a generic available I HAVE to take that. I will continue to give my generic a chance to work, maybe 6-9 months to see results? I haven’t seen any yet…I do believe I was experiencing a herx since I got so bad there for several weeks but then I broke down and TRIED a enbrel. I had one shot last week and that was it. I will probably not continue with it since it has me so scared out of my mind to use again. I really need just give AP the time it needs. Unfortunately I have a “large viral load” and am worried that the AP won’t work because of it. I’m looking in to high dose IV vitamin C therapy to get my EBV under control and in turn the AP can do its job. GOD I hope I’m on the right track. I can’t stand all the guessing and checking and trying and buying this and that.

    Diagnosed with RA in October 2014, pain started in February 2014
    Started AP in June 2015
    Taking daily: 32.5 mg WP thyroid 6 am, 100 mg mino 9 am, 16.25 mg WP thyroid 2 pm, B Complex for MTHFR mutation 3 pm, Multivitamin 3pm, 100 bil powdered probiotics 6 pm, 5-8,000 iu Vit D 6 pm, 100 mg mino 9 pm

    #375548
    frhorngal
    Participant

    I’m just curious about what others are paying for brand Minocin- I was able to get it from my local pharmacy for $50 a month. Would love to have my insurance cover it at the generic or slightly above generic price-

    RA/Lyme: 100mg Minocin (brand) MWF, 3mg LDN, 10mg CBD- BID

    #375549
    jasregadoo
    Moderator

    I pay $58 for generic. Brand is almost $1,000 on my insurance. I’d count myself lucky if I were you. 🙂

    #375550
    frhorngal
    Participant

    Wow…after doing a little bit of research, I am grateful that I am able to get the brand for this price- I had no idea it was $985 a month! I pay a lot for my insurance, but it has always been worth it for me-(it’s more than 3x the cost of other plans offered in my workplace)- I am able to find Integrative and functional medicine practitioners (including my new Integrative rheumatologist) that are in my network and most of my testing has been covered (after the high deductible of course).

    RA/Lyme: 100mg Minocin (brand) MWF, 3mg LDN, 10mg CBD- BID

    #375551
    Airen
    Participant

    I pay $30 for a 4.5 month supply for my generic. My dr writes the script for 100 mg twice a day every day. I take it once a day MWF. WITH insurance brand minocin would be $980!

    Diagnosed with RA in October 2014, pain started in February 2014
    Started AP in June 2015
    Taking daily: 32.5 mg WP thyroid 6 am, 100 mg mino 9 am, 16.25 mg WP thyroid 2 pm, B Complex for MTHFR mutation 3 pm, Multivitamin 3pm, 100 bil powdered probiotics 6 pm, 5-8,000 iu Vit D 6 pm, 100 mg mino 9 pm

    #375552
    jasregadoo
    Moderator

    I asked at my drug store today, and a few months ago brand minocin was $980. Now it’s $2,880! Insane. There’s something seriously wrong with pharmaceutical companies, in my opinion. I’ll stick with the generic, because I don’t have a choice. Yes, I could try Canadian pharmacy, and I’m considering it, but I don’t know how to tell if one is reputible or not.

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