Inexpensive Telehealth Appointment for 1 time visit?

[ST3]

My health insurance is covered with Kaiser which is an HMO in some states. I get migraines and get an RX every 3 months from them for migraine medication but my insurance changes from giving me 18 tablets every 3 months to now 9 tablets every 3 months.

The online price for an online pharmacy to get 18 tablets is less than $20 (it's weird...this particular generic is extremely expensive to buy in Mexico, Canada, and Germany but is affordable in the US if you have the rx here).

Because Kaiser is an HMO with their own pharmacy I cannot get my doctor to release a prescription outside of Kaiser so I'd like to have an online appointment in order to get an rx.

Anyone recommend an inexpensive online medical provider for a 1 time appointment? Not looking for a membership or anything like that.

Thank you ,

 

[barkley]

kaiser has care outside your home and non kaiser covered states-if you go on their website they have a page about it with their 'travel line' phone number. there is also information on how to get them to do a virtual appointment with you while traveling as well as how to have them arrange for a perscription refill at a non Kaiser pharmacy.

 

[tvguy]

I'm confused. Your insurance cut how many you can get, or your DOCTOR cut how many he wants you to take in 90 days? I would start with your Doctor and have him TELL the pharmacy to give you the number he feels you need. I would be very concerned that going outside your Doctor's supervision may put you in a situation where you are taking more than the safe amount in 90 days. Kaiser is very popular here and the big advantage my friends and family say it has, is. the Doctor orders it, you get it, no questions asked.

 

[ruadisneyfan2]

I'm confused too. Are you saying it's cheaper to just pay out of pocket for your prescription but your doctor refuses to write a script for that? Why should your doctor care where you get it filled? Why can't you explain your situation to your doctor and tell him it's cheaper to pay out of pocket?

 

[lanejudy]

my insurance changes from giving me 18 tablets every 3 months to now 9 tablets every 3 months

I also suggest checking with your doctor about why you've only received half the number of doses you used to get. It could be additional documentation is needed to get the higher number and the doctor can do that.

Why should your doctor care where you get it filled?

Kaiser HMO plans are typically a "closed" system requiring in-network. Doctors are capitated to specific pharmacies. It's probably part of the doctor's contract that they don't go outside the closed system.

kaiser has care outside your home and non kaiser covered states

Wouldn't that be if the OP was traveling and couldn't get home? It sounds like OP isn't away/out-of-state, they just want to use an online pharmacy. As noted above, the in-network provider probably cannot submit a prescription for that situation.

 

[ST3]

kaiser has care outside your home and non kaiser covered states-if you go on their website they have a page about it with their 'travel line' phone number. there is also information on how to get them to do a virtual appointment with you while traveling as well as how to have them arrange for a perscription refill at a non Kaiser pharmacy.

I'm not traveling. I've looked into buying the medication I need outside the US or via an online foreign pharmacy but this medication is often more expensive outside the US .

 

[ST3]

I'm confused too. Are you saying it's cheaper to just pay out of pocket for your prescription but your doctor refuses to write a script for that? Why should your doctor care where you get it filled? Why can't you explain your situation to your doctor and tell him it's cheaper to pay out of pocket?

Kaiser is an HMO with their own pharmacies. I cannot for instance take an RX from Kaiser and take it to Costco, Walmart, CVS etc.

The medication I use is not one Kaiser typically gives to people with migraines since it's more expensive than the one they typically put people on. I had to have my last doctor write a letter that this particular kind of migraine treatment was medically necessary for me due to having problems with the one that most people use. Not sure if any migraine sufferers are here right now who have an rx for medication. I was on sumatriptan which works for the majority of people. This did not work for me but rizatriptan the orally disintegrating tablet 10mg version works well for me. Sumatriptan seems to be the norm for treatment in the US and across the world because that treatment is cheaper.

 

[ST3]

I'm confused. Your insurance cut how many you can get, or your DOCTOR cut how many he wants you to take in 90 days? I would start with your Doctor and have him TELL the pharmacy to give you the number he feels you need. I would be very concerned that going outside your Doctor's supervision may put you in a situation where you are taking more than the safe amount in 90 days. Kaiser is very popular here and the big advantage my friends and family say it has, is. the Doctor orders it, you get it, no questions asked.

My Kaiser doctor said I can only get 9 every 3 months now and not 18. I'm on another medication where I used to be able to get a 3 month supply at a time but they cut it back to only 1 month at a time. I believe there were shortages but I'm not sure.

 

[ST3]

I also suggest checking with your doctor about why you've only received half the number of doses you used to get. It could be additional documentation is needed to get the higher number and the doctor can do that.


Kaiser HMO plans are typically a "closed" system requiring in-network. Doctors are capitated to specific pharmacies. It's probably part of the doctor's contract that they don't go outside the closed system.


Wouldn't that be if the OP was traveling and couldn't get home? It sounds like OP isn't away/out-of-state, they just want to use an online pharmacy. As noted above, the in-network provider probably cannot submit a prescription for that situation.

Thank you Lane. You pretty much answered this better than me.

 

[barkley]

Wouldn't that be if the OP was traveling and couldn't get home? It sounds like OP isn't away/out-of-state, they just want to use an online pharmacy. As noted above, the in-network provider probably cannot submit a prescription for that situation.

I assumed the op would be traveling outside a Kaiser covered region-i've had experience with migraine and other meds that I am limited on refills with so that it didn't time out well with a planned vacation. I made arrangements with my local pharmacy and my doctor but it looks like Kaiser now has a devoted division to help out members.

I'm not traveling. I've looked into buying the medication I need outside the US or via an online foreign pharmacy but this medication is often more expensive outside the US .

Kaiser is an HMO with their own pharmacies. I cannot for instance take an RX from Kaiser and take it to Costco, Walmart, CVS etc.

The medication I use is not one Kaiser typically gives to people with migraines since it's more expensive than the one they typically put people on. I had to have my last doctor write a letter that this particular kind of migraine treatment was medically necessary for me due to having problems with the one that most people use. Not sure if any migraine sufferers are here right now who have an rx for medication. I was on sumatriptan which works for the majority of people. This did not work for me but rizatriptan the orally disintegrating tablet 10mg version works well for me. Sumatriptan seems to be the norm for treatment in the US and across the world because that treatment is cheaper.

I have migraines/have an adult child with them. this sounds like it could either be an issue with the directives Kaiser doctors are under for prescribing (as in a 'no more than x number in y number of days) OR the Kaiser doctor's opinion on how many are safe to be prescribed within a set time period. w/some meds my/my kid's neurologists prescribed they had to get pre-authorization with the insurance company (and try us out on others first). an insurance company might say 'yes' or 'no' in covering (or limiting) but the doctor ultimatly could write a prescription for what THEY felt was appropriate and I could opt out of using insurance to pay for it. with some perscriptions over the years it was less expensive to use Costco and paying out of pocket than filling it at a contracted Kaiser pharmacy. Costco WILL take a Kaiser scrip but it will NOT go through insurance (for the most part all major pharmacy chains will take prescriptions from any licensed provider within their individual State, they just might not accept a particular insurance plan).

 

[lanejudy]

My Kaiser doctor said I can only get 9 every 3 months now and not 18.

The doctor should be able to get a formulary exception if you need 18. That seems so odd -- my prescription coverage does limit that product, but it's much higher - max of 108 ODT tablets for a 3-month supply (or 36 for 1 month). I'd really push that the doctor help you out with this, figuring out why you can't get it or what might be available instead (yes, I know you said sumatriptan isn't an option -- I can't take that either). A limit of 9 within a 3-month period means just 3 per month, which conceivably might only get you through one really bad day.

 

[ST3]

Hi guys, I'm really just looking for an inexpensive telepath doctor so I don't have to continue with the red tape at Kaiser which is another issue so if anyone has a recommended telepath service that is inexpensive for a one time visit in order to get them to write an rx I'm interested in recommendations. Kaiser wouldn't pay for botox for migraines because I didn't meet the minimum per month so I paid out of pocket for this. Certain things are just easier not dealing with an HMO.