Friday, December 12, 2008

More on compounding

So, I need to call my insurance company about the compounding. My previous post was replied to by a compounding pharmacist, so I sent her an e-mail.

Here are some things I learned.

Anything that requires compounding will require a prescription. Yes, that goes for acetaminophen and ibuprofen as well, two medications that are traditionally offered over the counter. It's for your safety.

Reimbursement amounts vary widely. When the insurance company reimburses a pharmacy for a compounded prescription, often they only reimburse the cost of SOME of the ingredients. Sometimes this doesn't include the cost of the inactive ingredients, and it doesn't include money to pay the pharmacist who took the time to do it.

Some prescription plans have their own compounding pharmacies. Talk to your prescription provider and ask them about their policies. They are there to help you.

Compounding pharmacies vary in the kinds of compounding they provide. Did you know you can get creams compounded? Some of the pharmacies only do creams. Others also do capsules. You really do have to call around. I personally started with Rite Aid -- I just asked the pharmacist there about a compounding pharmacy and she was able to give me the name of one.

And, finally...

What you hear over a phone call is not a guarantee of coverage. Be careful. I have been on the losing end of a couple of those conversations, where my insurance company denied that I had the conversation I said I had.

Hope that helps. I'll keep you posted on my progress.


Anonymous said...

Hi Susan , do you know what the legal acetaminophen or ibuprofen prescription should look like? What ingredients should it be compounded with? I want to ask my pediatrician to write one for my son, but have no idea if it is enough if she just write "pure acetaminophen"?? Tablet, syrup or something else?

Thank you

The SCD girl said...

Hi Agnieszka,

I would first talk to the compounding pharmacy to see what they suggest. Bring a copy of the legal supplement additives from this page:

Then, once you decide on the ingredients, you can go from there to your doctor and have them write the correct prescription.

Good luck!

Susan :)