Psycho-Babble Medication | about biological treatments | Framed
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Re: Meds and such

Posted by Shirley on January 6, 1999, at 23:12:42

In reply to Re: Meds and such, posted by Toby on January 6, 1999, at 16:22:42

> You have to request an appeal from your doctor to the insurance company stating that other medications do not work for you and that they cause intolerable side effects. It has to state that Remeron is effective for you with few to no side effects and that it is your doctor's medical opinion that Remeron is medically necessary to treat your depression and he requests that the insurance company cover the cost of the medication, less the usual and customary copay for other medications. (And you are correct about the cost. Remeron is $77 per month for #30 30 mg tablets and Prozac is $84 per month for #30 20 mg capsules.)

I lucked out with my Internist who now prescribes my Effexor. When my therapist prescribed it, I was in for quite a shock when the pharmacy informed that my Qual Med insurance wouldn't cover it. It would run me well over $125 per month, so I asked my internist to do as you have suggested, and make a case to my ins. co. justifying it. He said that was way too much trouble, and filled up a bag with samples for me. I would come back for more when I got close to running out, and he'd fill another bag. Those "free" samples have kept me going for over two months now!

We just switched to another insurance (Regence), so now I have a real prescription to have filled (I think they cover it--details like this are overwhelming to me!) I don't care about the copay. I just want to be a regular kind of human again!

Insurance companies have too much control over our health care, IMHO.




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