2017 Justin Goes to Battle with Insurance Part I
This article is for information only and doesn’t call for any action.
When Dr. M first prescribed the pills at that appointment, my prescription was denied, since the pharmacy needed to get “pre-authorization.” Apparently, a doctor’s orders aren’t enough. This wouldn’t have been a huge deal, but I was going out of town for a week and wanted to start the pills immediately.
Out of frustration and not wanting to have to drive back to the pharmacy, I ended up paying out of pocket for that first fill. It wasn’t too much of a difference from paying a copay through insurance, but it was the principle of the matter. I had taken a big step in asking for the help I needed before it got to too dark of a point again, but now I was being denied.
I got on the phone with the insurance company and the insurance liaisons at Dr. M’s office, and eventually we got it straightened out. They agreed to authorize me for the dosage we had decided to try.
When I went to go pick up me refill a few weeks later, there was no hassle. The authorization had been sent to the pharmacy, and my copay was slightly less than full out of pocket. However, I did feel vindicated – the insurance company recognized that this was a real thing.
However, the pills didn’t seem to be helping as much or as quickly as I expected.
Join the Mental Wellness FACEBOOK GROUP here.
image credit – pixabay
January 8, 2019 at 06:36PM