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why would an insurance company need a doctors authorization for meds?

they say they need to know why i'm taking the meds?

Answer Question

Asked by Anonymous at 1:43 PM on Apr. 14, 2010 in Health

Answers (8)
  • If it is an off-label use, meaning the company made it for one condition specifically and you dr prescribed it for something different, insurance won't cover it.

    Answer by mombychoice1982 at 1:46 PM on Apr. 14, 2010

  • Sad to say, but it is done all of the time. Many times they will not give approval to cover the med until they get the docs authorization. Just another insurance hoop to jump through (cost-cutting measures they call them in the insurance world). I would just get the auth from the doc and then get your meds.

    Answer by Anonymous at 1:46 PM on Apr. 14, 2010

  • Specially if your prescription is considered a "controlled substance" prescription medication.

    Answer by Energ8zr at 1:51 PM on Apr. 14, 2010

  • They will not give you the auth. The drug store has to get the auth. from the insurance co. It has happened a few times to me.The worst part is it holds you up from getting the meds that the Dr. thinks you need.

    Answer by Anonymous at 1:52 PM on Apr. 14, 2010

  • because MILLIONS of people abuse prescribed medication, that is why.

    Answer by samurai_chica at 1:52 PM on Apr. 14, 2010

  • ...another frequent reason is that the insurance company must tie a particular med in with a diganosis....depending on your status with the health insurance company, it might be considered pre-existing and they might not want to pay. Of course this may not be the case. You could also ask to speak with your insurance adjuster for further information in this regard.

    Answer by Anonymous at 1:54 PM on Apr. 14, 2010

  • i asked another question posted in health if anyone can help about pre existing conditions.

    Answer by Anonymous at 2:01 PM on Apr. 14, 2010

  • I know in my case the doctor has to have a blood test to verify levels. Then she will decide if the medicine should be left the same, increase dosage, or decrease dosage.

    Answer by hot_shuz at 2:28 PM on Apr. 14, 2010

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