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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by Glydin on November 10, 2007, at 19:47:01
Re: Folks in the US on RX drug coverage with private or group health coverage...
I, and a number of folks I know, have dealt with the hellish hassle of formulary versus non-formulary regulation, step programs, etc... this generally turning into a true fight and moaningfest of proper documentation to get coverage for ON LABEL usages of various meds in different catagories. That's *IF* you can be successful by crossing all the "T"s and dotting all the "I"s required. Even with the most careful attention and best advocacy, success doesn't always happen.
I read here of folks using a number of meds, pricey meds, BTW, off label (for the US) - Don't misunderstand, more power to ya if that's a good workable treatment but I wonder: Are you managing to get coverage for these componds or are you paying totally out of pocket or... what?
Posted by Phillipa on November 10, 2007, at 20:03:03
In reply to RX drug coverage, posted by Glydin on November 10, 2007, at 19:47:01
Good question I do know that some get regular supplies of samples from their pdocs. Phillipa
Posted by yxibow on November 11, 2007, at 1:26:16
In reply to RX drug coverage, posted by Glydin on November 10, 2007, at 19:47:01
> Re: Folks in the US on RX drug coverage with private or group health coverage...
Shall be unnamed PPO can charge quite a high maximum for things they don't want to pay for, no matter how much or little is prescribed. Other 50 year old generics can be pocket change.
Posted by Glydin on November 11, 2007, at 6:34:15
In reply to Re: RX drug coverage, posted by yxibow on November 11, 2007, at 1:26:16
> > Re: Folks in the US on RX drug coverage with private or group health coverage...
>
> Shall be unnamed PPO can charge quite a high maximum for things they don't want to pay for, no matter how much or little is prescribed. Other 50 year old generics can be pocket change.
~~~ Not uncommon as far as I have experienced. The true grrrr producer for me personally has been the removal of a brand named AD from a formulary, after being covered for several years, when its "cousin" med went generic.....AND switching without informing. That felt plain wrong to me.A friend of mine dx with fibromyalgia was interested in Lyrica and had to dismiss that idea.... no way she could get it covered unless there was a hx indicative of post-herpetic pain or neuropathic pain related to diabetes.
There's got to be some secret I and my circle of influence aren't aware of. (Smile)
This is the end of the thread.
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