Insurance/medication question

Discussion in 'The Watercooler' started by klmno, Dec 22, 2008.

  1. klmno

    klmno Active Member

    The office changed our policy type- same insuraance co and everything, just supposed to be different co-pays. I've been on a prescription allergy medication for several years and the insurance always covered about 80% of the cost. Then, this time they said they needed pre-authorization. The dr's office sent the paper work and the co denied it and won't pay anything toward it. Does anyone know if there's anything I can do about it to get the co to cover part of the cost? It's $148 if I pay it out of pocket- no other allergy medication works for me.
  2. hearts and roses

    hearts and roses Mind Reader

    You need to call your DR's office and have them contact the ins company and tell them that there is no other script that will work for you.

    The company may cover it after hearing from the DR but you will likely pay a higher co-pay because apparently, the drug of choice is not on the company's preferred drug list. I have a medication like this also. Everytime I submit a new script, I need to have my DR contact the insurance co. It bites, but it's better than having to change all your medications.

    I hate insurance gatekeeping practices.
  3. KTMom91

    KTMom91 Well-Known Member

    If they decide not to cover it, AAA offers prescription medication discounts at several pharmacies. That discount was a huge help for the six months we had to cover Miss KT's medications out of pocket.