HOUSTON -- "Your insurance is not going to cover this." The words all parents dread -- especially if your child is sick with the flu and you need to fill a prescription for liquid Tamiflu right away.
That's what happened to Tanglewood mother Tammy Kidd. Her pharmacy had to mix her Tamiflu prescription on site because of a nationwide shortage of the pediatric version.
"I got a phone call from the pharmacist saying they did not have any Tamiflu," said Kidd.? "And if I still wanted it, they could compound it for me, but if they compounded it for me then my insurance company wasn't going to pay for it."
Compounding Tamiflu means grinding up capsules and putting it into a liquid form for kids.
Many pharmicists are finding out insurance companies won't cover it.
"The norm in our industry is that when it's compounded, the insurance companies won't pay for it online," said Sylvia Peterson, director of pharmacy at Southside Pharmacy.? "And most pharmacies, they process all of their prescriptions online."
But there is something you can do about it.? You can ask your pharmacy to fill out a universal claim form and submit it to your insurance.? Still, it doesn't guarantee the compounded Tamiflu will be covered.
"Yes, they might deny paying for it because many times we do things from powders and they want a special number," said Peterson.? "And, sometimes the insurance will take it or not take it."
Peterson noted that Medicaid is paying for the compounded form of Tamiflu.?
If you're not sure, your best bet is to check with your insurance company.
As for Kidd, another pharmacy had the medication she needed and her insurance paid for it.
Still she doesn't want other parents to be caught off guard.
"I just think that folks need to be aware that just because you have a prescription for Tamiflu doesn't mean you're going to get it,"?Kidd said.
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