I was diagnosed with Hypersomnia in 2008. My Neurologist used to be able to give me samples of Provigil but, not anymore. Medicare will pay for Adderall/Amphetamines which my Neurologist says are dangerous for me because iof my history of seizure & stroke. I can't find anybody in this world to help me. I have NO quality of life just wanting to sleep all day. Any sugestions would be a Blessing.
Your neurologist should be able to explain the situation to your insurance company. Doctors are supposed to know how to talk to these companies. This is part of what you pay them for.
Yes, the neurologist needs to provide a letter of medical necessity to the insurance company. I got Nuvigil and Provigil approved in this way. The doctor may need a little kick in the butt.
Good luck. It is the neurologists job to get that approval.
Even a letter of medical necessity might not be enough. A while back my doctor switched me from Prilosec to Prevacid. I have to take two Prilosec and not get complete relief. The Prevacid allows me to take one and handles my GERD much better. I had some tests ran at the hospital and had that info she submitted to the insurance along with the letter of medical necessity. Still couldn't get them to pay, although the pictures showed even after being on Prilosec for two years, my stomach was still a mess and I had some fresh erosions in my lower esophagus.
You might want to check with the company that manufactures Provigal and see if they have a program that may help pay part of the cost of the medication.