Insurance FAQ
 

Arthrotec Is Listed As Non-formulary By My Insurance. What Other Drugs Are Used For Arthritis?

Question by Gary | Posted in Pain & Pain Management

Formulary is 2 times more than generic.
Arthritis is 4 times more that generic (Non-formulary).

Answer: Celebrex. You could call Walmart or go to WalMart.com and get a copy of their $4 rx list and take that to your doctor and make him prescribe you something off of that. So; you could afford it whether your insurance approved it or not.
 
 

What Is The Best SSRI For To Use For Bipolar Disorder Along With A Mood Stabilizer?

Question by Shekhinah | Posted in Psychology

I am on Lamictal (lamogtrine) as a mood stabilizer and the psychiatrist also prescribed Lexapro but it's not covered on my insurance formulary. They will prescribe Celexa, but I read that there may be problems with it when taken for bipolar disorder. What medications have you had good results with?

Answer: There is no one right medication for everyone. I have bipolar disorder and my body can't tolerate SSRIs, but I know of many people who do quite well with them in their med combo. Give the Celexa a try, it's the closest to Lexapro you can get on your insurance. Celexa is Lexapro's isotope, but everyone has a different reaction to medications so the only way to know what's right for you is to try it.

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Does Kaiser (HMO) Insurance Cover Prescription Medicines That Were Prescribed By A Doctor Outside Of Kaiser?

Question by dreamer | Posted in Insurance

If I get a prescription by a doctor who does not work in the Kaiser system, will my Kaiser insurance cover the medicine prescribed by that doctor? There is only one specialist for my condition in this area, and I would like to get a second opinion. The only way to do that would be to see a physician outside of the Kaiser system. If this doctor prescribes medicines, would Kaiser cover them if they are included in their formulary?

Answer: Usually Kaiser does not cover other doctors medicines unless it is a dentist. Call membership services and ask.

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My Mom's Insurance Doesnt Cover Her Chantix, What Options Do I Have?

Question by | Posted in Insurance

My mom is trying to quit smoking ( because she may have lung cancer ), and was given a trial of chantix, which seemed to help. However, my dad's insurance, Blue Cross/Blue Shield of IL ( though they live in WI ), apparently doesnt cover the medication for his particular plan. ( It's some quirky plan that just got switched over from a different insurance company. I dont think they have the option of selecting a different one because of the company they work for ).. Anyway, I've never heard of an Insurance

Answer: If your mother has a prescription she can still obtain it from the pharmacy. Here Chantix cost $140 for a 4 week supply and they recommend that you take it for 3 months but I didn't find it necessary to take for that long. My pharmacy said that there is not many insurance plans that cover this drug. The results far out weigh the cost. Good luck and best of health.

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Group Health Insurance Question?

Question by Love my LO! | Posted in Insurance

My husband and I have insurance provided thru his work. They will be renewing their insurance Dec 1 and were getting a little better plan, anyways we will be having a baby in Janurary and since its a group health insurance plan thru Blue Cross Blue Shield will we be able to add the baby when she is born or do we have to wait until next year when they do open enrollment again? And what does "closed formulary"and "Open Formulary"mean insurance wise?
Ok thanks, so I have up

Answer: You add the baby right when she is born. Although you have 30 days to add her, it goes back retroactive to her date of birth.

Be SURE to apply for her SS number right away, as most of the time the insurance company won't add her without that. BE ABSOLUTELY SURE to track, firmly, in writing, your request to add her to your policy! Whether it's fax, email, certified mail, etc, because on day 31, if someone in the HR office "loses" the paperwork, you are SOL on adding her until the next open enrollment.

Closed formulary and open formulary is whether or not the medication comes in a generic.

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The National Medicare Training Program: Medicare Prescription Drug Coverage. Part 2 of 2

Answers to a common scenario Medicare beneficiaries or caregivers may experience when asking questions and making choices related to prescription ...

Discovery Health "How Prescription Drug Benefits Work"

Let's find out what's going on. Any insurance plan's prescription drug coverage includes a formulary , or a preferred drug list. A formulary can have several forms, depending on your exact insurance plan. Some plans will cover drugs that are on the formulary ( preferred One main purpose of the formulary is to encourage you to use the generic form of a given drug. This list is created to keep the drug costs down for the insurance company while still offering you a competitive choice of medications....

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