Posted by JohnB on September 28, 2000, at 2:27:59
In reply to Re:Paxil v Serzone--insurance , posted by stjames on September 26, 2000, at 23:51:24
> James here....
>
> HMO's, as a cost containment procedure, have what they call "formalary". This is a list for meds they will pay for. In general this is not a bad idea, doc's do not need acess to evey antibiotic to treat people. It is different for things like the psuco meds. Both the AD's I take are non-formalary and are the olny (and when I say only I mean EVERY AD out there, excet MAOI;s) It has been a tap dance with the HMO to get these meds. The %(&%(& HMO pays a 3d party to process Rx approlals. The HMO does not have a problem letting me get these meds, it is getting this info to the 3d party so i do not have to pay retail for 60 150 mg Effexor and 15 30mg Remeron and wait 3 months for the HMO to pay me back.
>
> So the first time I the I went without meds and sleep for a week and the HMO customer service was no help I called my doc and asked to be admitted as a danger to myself. I got my meds. I also got the special phone # for overrides on Rx's that only the doc were to use. next time it happened I used the "special number" and they were real pissy till I told them I was a crazy person and
> b4 i blew my brains out becuse of no meds i would come over to their office and mow them down. One can be very convincing with no sleep for a week, crashing off Effexor. Cilck...I had a manager on the phone. Meds...no problem ! I told them in the future I would just admit myself, at a cost of $2,000 and hold them resopnsible for all mental trauma, anyone I killed, ect. For about a year I would call them a week b4 I refilled and I had no problems. Then they said they fixed it so I did not have to warn them. I have had no problems for a year now.
>
> It is sad that I pay $420/mo and have to resort to these tatics.
>
> jamesJames:
If for some reason they didn't allow your meds, would you try the Mexico alternative? Meds so cheap down there and you live not to far away. I think you mentioned once that you had to do that. I think I read somewhere that you can get a script from a Mexican doc and get it filled all in about half an hour. Of course in Mexico you don't need a script for a lot of meds, but to bring your 90 days supply back across to the US, you need to show some kind of script, right? Or do you need a script from a US doc? Just curious. --JB
poster:JohnB
thread:216
URL: http://www.dr-bob.org/babble/20000926/msgs/45397.html