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Mom Confessions Mom Confessions

So the insurance trumps whatever the dr says?

Anonymous
Posted by Anonymous
  • 26 Replies

Why even go to the doctor if they insurance company is going to tell them that they can't prescribe it that way? Seriously!

Posted by Anonymous on Sep. 30, 2013 at 7:15 PM
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Replies (1-10):
Short_cake88
by Gold Member on Sep. 30, 2013 at 7:44 PM

I just fight with them until they let me. I've had bad reactions to some generics, not all, but several. And my anti depressant has to be brand - so I've had to cal several times.

Short_cake88
by Gold Member on Sep. 30, 2013 at 7:44 PM
Or make your dr. Call. They tend to listen to them on the phone
drowningmama
by Platinum Member on Sep. 30, 2013 at 7:45 PM
Agreed
Allie_kat1
by Gold Member on Sep. 30, 2013 at 7:46 PM
Your dr can call, or you can pay out of pocket.
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Not_A_Native
by Ruby Member on Sep. 30, 2013 at 7:47 PM

They aren't saying your doctor can't prescribe it - only that the insurance company won't pay for it.  Not all insurance companies will pay for name brand.  You may have to pay out of pocket if you want what the doctor is actually prescribing.

Anonymous
by Anonymous 2 on Sep. 30, 2013 at 7:47 PM

So true! It's annoying.

Anonymous
by Anonymous - Original Poster on Sep. 30, 2013 at 8:11 PM


In the letter I received they said that they already told my doctor the same thing. 

Quoting Short_cake88:

Or make your dr. Call. They tend to listen to them on the phone



Anonymous
by Anonymous - Original Poster on Sep. 30, 2013 at 8:13 PM

Have you had to buy many prescritions out of pocket? This one is $130. they will pay for half of a months worth but not the other because they don't deem it "medically necessary."


Quoting Allie_kat1:

Your dr can call, or you can pay out of pocket.



Anonymous
by Anonymous - Original Poster on Sep. 30, 2013 at 8:14 PM


It isn't even the name brand that is the issue. They refuse to cover it as prescribed and there is no way I could pay out of pocket for it. 

Quoting Not_A_Native:

They aren't saying your doctor can't prescribe it - only that the insurance company won't pay for it.  Not all insurance companies will pay for name brand.  You may have to pay out of pocket if you want what the doctor is actually prescribing.



ColleenF30
by Lube Girl on Sep. 30, 2013 at 8:41 PM

I had an issues that medicaid would not pay for generic Lovenox. Name brand only wtf???

Quoting Not_A_Native:

They aren't saying your doctor can't prescribe it - only that the insurance company won't pay for it.  Not all insurance companies will pay for name brand.  You may have to pay out of pocket if you want what the doctor is actually prescribing.


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