Copay Question - Pain Management Message Board

rollaj · 06-24-2008, 01:16 PM

I know there are many people paying for meds out of pocket, so I dont want to come off as whining when others may have it much worse...That being said.
Since percocet is a controlled substance, I am told:

1) it can not be prescribed with refills
2) I must go in for a check up everytime I need a refill.

(are these both true?)

So every time I need a refill (every month about) I must go in and pay a $25 copay for the Dr. to say "still hurts?" I say "yes" he writes a script.

Any way around this? with the $10 medicine copay, it means I pay $35 for a refill that should cost only $10

Fabrashamx · 06-24-2008, 01:24 PM

Hi Rollaj,

Welcome to the pain boards. It is up to the doctor as far as seeing you, a doctor would probably not prescribe for long without getting investigated if he didnt do regular check ups.

It is federal law that schedual 2 meds cannot have refills on them, but some doctors allow patients to come in and pick up a written prescription and only see them every other month, depends on the doctor and the rules of his practice and malpractice insurance guidelines.

So refills against the law, but seeing you each month on the dot varies from doctor to doctor.

My doctor sees me every month as well, many doctors do prefer it and it is ideal for them incase they were ever investigated.

Do you have a diagnosis yet? sometimes that makes a difference.

You could always ask if he would be willing to see you every other month and let you come pick up a script in between, but dont be surprised or take it personally if he says no.

HTH!
Fabby

Moldova · 06-24-2008, 01:37 PM

I agree that this is up to the DR. I see my PM ones in 3 month. He prescribes my meds when I see him and gives me prescription to hold on to it when I need my refill. For example Oxy can't be prescribed over the phone, but Percocet no problem: he calls in and they refill it for me without a problem.

I think also depends on relationships between patient and a DR. He knows I am very responsible and will not refill meds before time, so he has no problem giving prescription for next 2 month. Or maybe Drs have another reason, who knows?

My co-pay is $40.00 for DR app who participate my insurance and the whole amount out-of network. I pay $100.00 for 3 month supply of Percocet (pharmacy co-pay) and $40.00 for one month supply of Oxy.
Not easy, you are so right!

Good luck to you.

rollaj · 06-24-2008, 01:39 PM

I have pretty standard (i think) lower back pain. MRI showed 3 herniated disks, and he said it looks like a little arthritis starting too. I guess I will ask next time I see him if I can do the every other month thing, the extra $25 isnt killing me, but it is certainly a waste.

rollaj · 06-24-2008, 01:43 PM

I dont think it can be called in in NY, but I will check that too. I thought in regards to that, that percocet would be treated the same as oxy