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Epileptic prescriptions that I take the insurance company is not covering the amount that I need per month. They are knocking one off per day per month instead of sending me the full refill. I’ve been on Medicaid since losing my last full-time job last February. This is inexcusable and unacceptable and I’m furious about it.

September 20, 2025
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A MyEpilepsyTeam Member

My refills are refilled automatically by my pharmacy every month!

September 20, 2025
MyEpilepsyTeam

This situation sounds incredibly frustrating, especially since consistent medication timing is crucial for preventing breakthrough seizures. Missing even one dose can increase the risk of seizures, and epilepsy medications must be taken exactly as prescribed to be effective.

Here are some immediate steps to consider
• Show Full Answer

This situation sounds incredibly frustrating, especially since consistent medication timing is crucial for preventing breakthrough seizures. Missing even one dose can increase the risk of seizures, and epilepsy medications must be taken exactly as prescribed to be effective.

Here are some immediate steps to consider:
• Contact your neurologist right away to document this issue
• Ask your doctor to submit a prior authorization to your insurance
• Request your doctor's office to provide documentation of medical necessity
• File an appeal with Medicaid regarding the coverage restriction
• Consider reaching out to the medication manufacturer about patient assistance programs While working to resolve this issue, it's important to maintain your exact dosing schedule. Consider keeping detailed records of:
• Your current medication supply
• Dates of attempted refills
• Communications with insurance and healthcare providers
• Any breakthrough seizures or symptoms

This documentation can help support your case for full medication coverage.

September 20, 2025
A MyEpilepsyTeam Member

OptumRX is with United Healthcare

September 23, 2025
A MyEpilepsyTeam Member

I use OptumRX mail service

September 22, 2025
A MyEpilepsyTeam Member

I also learned I should name a Representative to make appeals on my behalf. I have a Conservator, so it makes sense she do that.

December 15, 2025

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