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The Watercooler
Can't find it, and with-o it I am in heap big trouble (rant)
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<blockquote data-quote="nvts" data-source="post: 201278" data-attributes="member: 3814"><p>That's great! It drives me nuts when they just throw up their hands in the doctors office AND the insurance companies and leave us floundering!</p><p> </p><p>I hope this one works. If not, then most insurance companies step away from their formulary (which is the list of medications that they readily approve) and will authorize with a slightly higher co-pay, so don't go straight to them compounding it. It could end up WAY more expensive for you.</p><p> </p><p>Here's what I mean.</p><p> </p><p>Most ins. co's have a formulary, which means they buy generics and name brands from one or two of the major pharmaceutical companies in bulk thus their cost is lower. If it doesn't appear on their formulary they first want you to check with the dr. to see if they can switch to another type of medication (extremely common with antibiotics). If they can't due to an allergy, oversaturation via past usage, etc., the dr. writes a letter stating as such, it goes to a supervisor/advising nurse to go off formulary. It usually has to have a different chemical composition to get authorized, but ins. co's are hesitant to say "no" because it makes them extremely exposed if something goes wrong.</p><p> </p><p>THEN if (for some reason) none of them on the market work, it goes to compounding which you can fight with the insurance company about how much you're required to spend out-of-pocket AS WELL AS calling the company that produces the other products to see if they have an assistance program.</p><p> </p><p>You might also want to look up that company that Montel Williams has been actively involved with that helps families that can't afford their medications.</p><p> </p><p>Don't settle for chalky bones Susie! I'll help you dig if you need it! <img src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" class="smilie smilie--sprite smilie--sprite2" alt=";)" title="Wink ;)" loading="lazy" data-shortname=";)" /></p><p> </p><p>Beth</p></blockquote><p></p>
[QUOTE="nvts, post: 201278, member: 3814"] That's great! It drives me nuts when they just throw up their hands in the doctors office AND the insurance companies and leave us floundering! I hope this one works. If not, then most insurance companies step away from their formulary (which is the list of medications that they readily approve) and will authorize with a slightly higher co-pay, so don't go straight to them compounding it. It could end up WAY more expensive for you. Here's what I mean. Most ins. co's have a formulary, which means they buy generics and name brands from one or two of the major pharmaceutical companies in bulk thus their cost is lower. If it doesn't appear on their formulary they first want you to check with the dr. to see if they can switch to another type of medication (extremely common with antibiotics). If they can't due to an allergy, oversaturation via past usage, etc., the dr. writes a letter stating as such, it goes to a supervisor/advising nurse to go off formulary. It usually has to have a different chemical composition to get authorized, but ins. co's are hesitant to say "no" because it makes them extremely exposed if something goes wrong. THEN if (for some reason) none of them on the market work, it goes to compounding which you can fight with the insurance company about how much you're required to spend out-of-pocket AS WELL AS calling the company that produces the other products to see if they have an assistance program. You might also want to look up that company that Montel Williams has been actively involved with that helps families that can't afford their medications. Don't settle for chalky bones Susie! I'll help you dig if you need it! :winking: Beth [/QUOTE]
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Can't find it, and with-o it I am in heap big trouble (rant)
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