r/ADHD • u/Space-Useful • 2d ago

Seeking Empathy My medication went from $31 to $130.

I'm really frustrated right now and I would like to know if anybody has experienced sonthing similar. So I'm on Methylphenidate and I would pick it up from my local walmart for $31 dollars. Starting this month, it randomly shot up to $130. I called my insurance, they said it was somthing up with walmart. Talked to my walmart pharmacist and she said that nothing has changed with walmart in terms of a manufacturing change and no changes to my prescription has been made.

I had to bite the bullet and pay to get the medication (I'm afraid of abruptly stopping it). I plan in calling my insurance again but this is just very upsetting.

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476

u/Thebakers_wife 2d ago

Walmart may have stopped accepting your insurance

148

u/Jasona1121 ADHD 2d ago

This might be it since they randomly stop without notice. My pharmacy randomly stopped taking my insurance last year and nobody bothered to tell me until I showed up to pick up my meds

39

u/the_noise_we_made 2d ago

Then why didn't they just tell them that?

37

u/frsh2fourty 2d ago

It may not give them that info on the computer or maybe ops specific policy doesn't cover that pharmacy while they still accept other policies from that insurance carrier.

Work changed my insurance this year but I verified the pharmacy accepted that carrier before having the doc call my script in. I went to pick it up and they charged me full price saying their computer was telling them my insurance was invalid. When I asked what they meant by invalid they said that's all it shows, just status: invalid. After a phone call I found out that while my insurance is accepted at that pharmacy, it's not for 90 day fills which is what I normally get and they only have 2 pharmacies that they approve for 90 day fills.

25

u/bookchaser Parent 2d ago

This is where using a locally owned pharmacy pays dividends. With any sort of billing irregularity my local pharmacy looks into it while I stand there. One time they got me a better price on a medication because of the medical provider I use, and didn't run my medication through my insurance. I didn't even know the opportunity existed.

10

u/invisible-bug 2d ago

I go to CVS next to me and this is the stuff they do for us. They pushed through a refill on a controlled medication for my SO a few weeks ago even though it wasn't time yet. Just the most recent example

I think it's more about good peeps.

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u/bookchaser Parent 1d ago

My experience with CVS is of them not being able to maintain staffing levels, being closed during the weekday lunch hour, and being closed on weekends. The pharmacy, not the overall store. Any time of day I'd go there, I'd be faced with a long line.

When the ADHD med scarcity started, they couldn't get any. I checked in about once a month. In the third month I was told face-to-face they got the meds in, but I didn't pick them up. I was not texted/called/e-mailed like they normally do, and when I didn't respond, they put the meds back and some other customer got 'em.

That's when I called around and discovered my locally owned pharmacy could obtain the meds. They even do home delivery, which CVS does not do in my area. Even today, that CVS hasn't changed.

1

u/bugbia 1d ago

I worked at a large chain pharmacy for years and we did that too. We would have also known and said right away if the insurance was no longer accepted.

1

u/BamBam-BamBam 1d ago

Or, since generics are made overseas...