Those of you who have children enrolled in insurance through WVCH (Willamette Valley Community Health) who are being treated for ADHD may have run into some issues lately regarding your child's medication coverage. The health plan has enacted some stricter rules about which medications are covered as well as some restrictions on treatment under age six and over age 18. Higher-than-usual medication doses are also being scrutinized.
Families affected by these rules changes (which took place July 1) should have already received a letter though the letters don't necessarily state the reason that medication coverage might be a problem. If your child takes his or her medication through the summer and you've filled the prescriptions since July 1 without any problems at the pharmacy then you are probably fine. If you have experienced issues picking up the prescription and haven't contacted us, please do so right away so that we can determine how best to help your child with their medication coverage.
If your child doesn't take medication during the summer and you received one of these letters from WVCH, it would be a good idea to get the September prescription from us early and take it to the pharmacy now so that we have time to work out any issues you may have. Please be aware that it typically takes about four working days for us to work this out with the health plan and get the medication covered. In some cases we will need to switch to a different medication or make a dose change instead.