question about pre existing and prescriptions??

mywaydown

New Member
We have Blue Cross Blue Shield and get different answers. It is through my husbands employer.
Do any of you know if the pre existing conditions exclusion applies to prescriptions?
Shelly
 

tiredmommy

Well-Known Member
Well, we just changed providers. My birth control was covered under the new contract with no problem even though the new script was dated before our coverage took effect. Do you have a contact person at husband's work who could help you get a final answer?
-TM
 
O

OTE

Guest
Any insur carrier including BCBS has hundreds if not thousands of plans. So it's not a question of what BCBS covers but what the plan you are in covers. State law often requires plans to cover certain things such as pre-existing conditions. So to some extent it's also specific to your state AND your plan. If you can't get an answer from BCBS or your husband's employer, try the state insurance office.

Logically speaking, if this medication prevents something bad from happening, eg your husband's heart medication, they should cover it. If not, they could end up covering husband's hospital stay, rehab, etc. Certainly a LOT more money for them. So I don't see why they wouldn't cover it.
 
I wonder if they would spend the time and money to track down every prescription to see if it is for a pre-existing condition or not. I have never had a prescription rejected on this basis.
 
Originally posted by OTE:
[qb] Logically speaking, if this medication prevents something bad from happening, eg your husband's heart medication, they should cover it. If not, they could end up covering husband's hospital stay, rehab, etc. Certainly a LOT more money for them. So I don't see why they wouldn't cover it. [/qb]
Unfortunately LOGIC doesn't seem to enter into an insurance company's decisions. They will pay to rent medical equipment, even if the rental ends up costing more than buying than item would have. That makes no sense. Expediency is too often their criteria for payment.
 
Top