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Why do you have to fail on a med before they cover the one that will work for you?

I was told that I have mild PPD, ok I can handle that. Doctor prescribed a medicine and later I found out many in my family has been taking the same medicine(Lexapro). I have always been scared to take such things and my family doesnt really talk about PPD or issue like this. Anyways, doctor called in the medicine to Base(dependant of Active Duty)-they dont cover it@! They told us we have to fail on other SSRI(anti depressive drugs) before they will authorize one that costs a little more. Gesh! Right before my delievery of my baby they tried to change my asthma medicine because of cost and I had not failed on the other drug. Now really why should someone fail on a medicine that could cause death or worse damage than the original diagnoses? I suffered 2 yrs active Asthma attacks because they would only treat it as GERD, gotta just love someone playing god with your own health.

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Anonymous

Asked by Anonymous at 11:23 AM on Sep. 24, 2009 in Health

Answers (2)
  • All insurance companies have policies about what and when they will cover things.. If medication that is cheaper will work there is no reason to cover the ultra expensive medication. You went to have this filled on base, if it isn't on their full frmulary you can always take the script out in town and pay the co pay of it is so important to you. How do you know one of the other SSR drugs won't help you?
    Anonymous

    Answer by Anonymous at 12:16 PM on Sep. 24, 2009

  • well gee because my doctor compared it to other meds I am taking- the othersould either make the condition worse or kill me- nice thing about private insurances is you can tell them to stuff it(did so many times when I was a civilian) now the govt has complete controll..
    Anonymous

    Answer by Anonymous at 5:32 PM on Sep. 24, 2009

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