Monday, February 13, 2012

Q&A: Insurance Company Authorizations

Insurance company authorization of medications can be challenging for both patients and physicians. Proton pump inhibitors, because of their cause are commonly affected. Thankfully, because there are generic and over the counter proton pump inhibitors available, there are options. You should check wi...
2/ 9/09 2:15am

I am also on twice daily Prevacid, and my insurance would not cover Prevacid at all (I just a few months ago got insurance, I did not have it for a long time).  I was going to the doctor at a clinic located at and affiliated with a hospital, and they had a staff member whose job it was to try to help patients in this situation to get assistance with their medicine costs.  He was able to get me on an assistance program for one dose of Prevacid a day, and then I found out that Prevacid (which for one-a-day dosing cost $255/month at Walgreens by my house), I could get at the hospital's pharmacy, because I was a "clinic patient", for cost (what the hospital pays for the drug), which was $11.15 (so that was my second dose per day)!!!!!  At this particular clinic, ***you do not have to be low income***, they take almost any type of insurance, it is something worth checking into.  This is not a *neighborhood clinic*, though, this clinic is located as part of a hospital, and affiliated with the hospital (and a nearby university), that is why I think the care is so good, because they have so many great resources available. 

 

Even when I was uninsured, they took me, and went by my income.  Everyone pays something, but they really do make it affordable.  It was (and is) a blessing.  I have seen specialists at the hospital and had tests done, and because of their care, my condition is able to be controlled by medication a lot more so than it used to be.  Clinics have a bad rap, and probably some of them deserve it, but this one is a gem no one seems to know about.  It is an hours' drive away, in a major US city, but well worth the trip. 

Anonymous
Anonymous
11/22/09 8:27pm

You just have to get the Doctor to write a letter to them stating that other meds have not worked and that you require the twice a day medication.  Then they will usually approve it for some defined period of time.  Yu may have to work on the doc though, in many cases, they are reluctant to write the letter, not sure why, if you insist, they usually will.  You have to be your advocate!  If the doc will not, change doctors!

Anonymous
Anonymous
11/22/09 8:28pm

You just have to get the Doctor to write a letter to them stating that other meds have not worked and that you require the twice a day medication.  Then they will usually approve it for some defined period of time.  Yu may have to work on the doc though, in many cases, they are reluctant to write the letter, not sure why, if you insist, they usually will.  You have to be your advocate!  If the doc will not, change doctors!

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