1139443 tn?1369553584

Insurance Nighmare

I really don't understand insurance company policies concerning our meds.  I just had my pain med filled-no problem.  The problem I have is with my Zofran for nausea.  They will only let me have 8 pills a month.  (My last insurance company let me have 24.)  My doctor tried to get a pre-cert for more and that's all they'll let me have. After watching a commercial on tv about how they're all about quality of life, I wrote them a nasty email explaining my situation and telling them that I have to decide how nauseous I have to get before I took a pill and wonder if the 8 will make it till the end of the month.  All I got back is how my doctor should get a pre-cert.
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351246 tn?1379682132
While I can understand your concerns, I really do not know how to deal with the insurance companies. One way that once worked for me was to talk to my agent. He helped me understand the fine words.
Other than this, you could also opt for generic versions of the prescribed medications. These are cheap but equally effective. Take care!

The medical advice given should not be considered a substitute for medical care provided by a doctor who can examine you. The advice may not be completely correct for you as the doctor cannot examine you and does not know your complete medical history. Hence this reply to your post should only be considered as a guiding line and you must consult your doctor at the earliest for your medical problem.
Helpful - 0
1139443 tn?1369553584
I had been using the generic.  

My doctor found out after 6 months of this insurance, that our company has a dedicated pre-auth line (Nobody had given out this info and it wasn't on our cards.  I have since given this number out to a number of co-employees having problems and also to HR).  Our company, it seems, has better coverage than the national product and I was supposed to be able to obtain 25 pills a month all along.  I gave this info to my pharmacist with the new number and got the pills I should have been getting all along.
Helpful - 0
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