Problems getting meds covered anyone? income doesn

I’very taken Ritalin for over 25 years and Nuvigil was added about 5 years ago. Last week I went to pick up my Nuvigil and was told that it would be almost $600 monthly because my insurance would no longer cover it! I’m retired and my income isn’t enough to pay that. Has anyone else had this problem? They want another sleep study but will not guarantee coverage even if I do another one. Do they think people outgrow narcolepsy?

I have had issues in the past, but currently insurance covers my provigil 60 pills 200mg a day. I have had to have my insurance get a prior authorization many times. Ask your Doctor if that is a possibility. The price of these prescriptions are ridiculous!!!

Yes when I first found out about my narcolepsy. They put me on Nuvigil, the first time we bought it it didn’t cost that much and it worked great for me. Then my husband went to get it refilled and was told it was going to be over $500.00 cause our insurance was only going to cover $100.00. I went back to the doctors and got on Modafinil. It only cost me $7.00. Now I take 400mg of Modafinil, 10mg of D-Amphetamine salt combo, 25mg of metoprolol, 20mg of citalopram, 500mg of magnesium and 400mg of cq-10. I don’t drink caffeine drink’s anymore and only eat very little chocolate.

Hope that help’s :slight_smile: I tend to go off topic lol

Thanks for these ideas. Insurance turned down the prior authorization for methylphenidate so i’m not very hopeful about getting approval for Nuvigil. I’ll ask my doctor about some of the other ones.

I was checking into Adrafinil but I thought they took it off of the marker

I suggest you contact the pharmy company and ask for "compassionate care" assistance with the drug cost. Explain your situation and use the phrase "compassionate care" help.

Please let us know how it works out.



I bought it online and it shipped from FL. $24 a bottle free ship. I keep buying it because my husband, he has ADD but hates ADD drugs and does not take any meds at all. So he tried my Adrafinil and boom! It helps him. He says it doesn't give him the annoying boost of energy adderall does, nor the tourettes.

Froggzzz said:

I was checking into Adrafinil but I thought they took it off of the marker

Modafinil does not make my teeth sensitive, Adrafinil did, just a little, and I got used to it after a week and I guess I got tolerant.

Virginia said:

Now I know why I have sensitive teeth thanks for the info !

Narkie said:

I had the same problem in the past, with Nuvigil and Provifil/Modafinil. Nuvigil does not help me, I took it because my insurance wanted me to try 2 meds and fail to approve Modafinil/Provigil. Once approved I could not afford it because they only approved 30 pills of 100mg per month and I need 300mg a day. So my prescription was going to cost me $1500. Desperate I started researching and found out Adrafinil. Ask your doctor about it and Google it, read all you can and keep researching. Adrafinil is the main metabolite of Modafini/Provigil, it's considered a vitamin supplement. Once absorbed your body metabolizes it into Modafinil, so the dose has to be higher. I tried it for 2 months and it worked for me. Then my full prescription of Modafinil was approved by my insurance and don't take Adrafinil anymore, but my husband does. He has ADD. He says Adrafinil makes him alert and focus. The only difference between Modafinil and Adrafinil I noticed was sensitive teeth, just a little more sensitive than usual. Research about it and ask your doctor. It cost $24 a bottle of 30 pills. No prescription needed, 100% legal. Did you know that Modafinil & Nuvigil cost between .50 cents and one dollar per pill in India and Mexico? And here they sell them for $20 bucks per pill. They are made by the same companies. Our pharmaceutical and political system is what's wrong, and we are the one who suffer and foot the bill. Good luck.

There have been recent posts about the supplement Adrafinil here. Adrafinil is marketed as a supplement and isn't approved by the FDA in the US. It was taken off the market in France by their regulatory agency citing adverse side effects and poor risk to benefit ratio.

Please discuss all medication and related decisions with your doctor.

It was taken off the market in France by their equivalent to the FDA in the US, citing adverse side effects and poor risk to benefit ratio.

Froggzzz said:

I was checking into Adrafinil but I thought they took it off of the marker

Yes, but with another medication. Sometimes an insurance company requires that a patient try cheaper medicines first. If you've already done that, had limited success, and Nuvigil is the best option to treat your symptoms your doctor can write a letter stating that and you can appeal the insurance company decision.

Virginia's suggestion about asking the drug company about "compassionate care" help with cost is a good idea, too.

Some medical centers have charity care for low income qualifying patients, but prescription costs aren't always covered.

I hope you find a way to work it out!

Thank you for your help. I talked with the manufacturer but they were unable to help me. I have called my doctor 4 times in the past week but have been unable to speak with her yet. I’m already taking 70 mg of Ritalin daily and don’t want to incense that. My frustration is mounting and my patience is wearing thin. Could any side effects of adrafinil be any worse than taking more Ritalin?

I don’t qualify for low income but that doesn’t mean I can afford almost $600 a month for this prescription! Plus I have other medications to pay for, and had of them are $38 monthly even after my insurance.

The low income limit at your hospital may be too low for you, but you might check to be sure. I was surprised how high it was at two area hospitals where I live.

I understand you may have many more expenses, especially for any prescriptions, co-pays, and medical devices. Be sure to list all of them on any application for assistance or compassionate care.

Have you asked your doctor to help you appeal your insurance company decision?