EPI

I have been using OTC stuff including "Now Plant Enzymes" to digest grains and fats and generic Bean-O for digesting cruciferous veggies and beans.  These have helped increase my energy level after eating and they also reduce bloating/gas/trips to the bathroom.  I pair that with organic psyllium husk powder to bulk up the stool and give my digestive system more time to absorb nutrients from food - it reduces the watery stool effect and decreases transit time. Not sure if this combination will have the same intensity or impact as CREON, but it could help and it's way cheaper. 

Usually the first step is to appeal the denial of coverage for the Creon. Do you know why it was denied?  If you have a Medicare Part D (drug) plan that would be where to start.

Thank y‘all

was told by doctors assistant that Creon is NOT or never covered by Medicare.

I’ll call Medicare first thing Monday morning.

Another avenue to try is to ask your doctor for a different Rx that is on your Medicare formulary. Often there are generic or other brands that are covered. Plus, it is possible that your doctor needs to prescribe it as an exception to override the non-formulary restriction. But Medicare can be tricky.

I did a quick search online and it seems that there are 5 brands of pancreatic enzymes that are FDA approved. Individual plans may have coverage for one or another brand. If you can look up the Medicare formulary for your plan, that will get you a head start on what to ask for. Formularies are not the same for all Medicare plans. Plus, if you do not have a Medicare part D plan or Advantage Plan (which includes part D) you really need to add it if you can. You have until March to change your plan if you are already in an Advantage plan. I did that once, but I’ve always have had an Advantage plan. You can contact Medicare to see what options you have, since you just found out about this new diagnosis.

Of course, you could go with OTC enzymes, but they are sold as supplements and are not regulated.

Jan

Thank you Jan for the research. So sweet!

I’ll get into action Monday morning.

The Creon web site says that most Medicare Part D insurers cover Creon (or at least did in 2024). Calling Medicare directly probably won’t help, since the drug coverage is always handled by a 3rd party. It would be best to contact whatever entity handles your prescription drug coverage.

Thanks Scott, I have the original Medicare A and B with a supplement insurance by Aetna and you’re right the plan D drug coverage is  with a third party. In my case with Aetna.  Perhaps I should switch to an Advantage plan as well.  Hopefully I’ll get some answers on Monday.

thanks again for your help!  

I’m not a big fan of Advantage plans, but that’s a different question than why your Creon was denied, and how to try to get it covered. Both Advantage and Part D insurers sometimes deny medications.

@grateful I also use Part D as my drug insurance coverage, and have always paid less for the mega $$$ pricey meds by asking my doc to fax the prescription to a Canadian pharmacy. I happen to use Mark's Marine Pharmacy (website is https://canshipmeds.com/ ).

The downside is the meds are shipped to you, so you won't have them "same day", but the folks at Mark's Marine have a toll free number and the pharmacists are always super helpful in walking me through the sourcing and shipping options.

I hope the medication, however you procure it, proves helpful for you.