Does it specifically state in her Blue Cross policy that they don't cover compounded or name brand drugs? If it does then they really don't cover it. If it doesn't state that then you could appeal it.Instead of having an individual plan just for her that doesn't seem to cover everything she needs, is there any way that your husband or you can get a job that does offer health insurance? In our case, my husband would never even consider a job that did not offer a health insurance plan. It's absolutely vital to our family. We do still pay quite a bit in co-pays, but that is one of the reasons why I work.
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Navigating health insurance
- Thread starter froggymama
- Start date
Does it specifically state in her Blue Cross policy that they don't cover compounded or name brand drugs? If it does then they really don't cover it. If it doesn't state that then you could appeal it.Instead of having an individual plan just for her that doesn't seem to cover everything she needs, is there any way that your husband or you can get a job that does offer health insurance? In our case, my husband would never even consider a job that did not offer a health insurance plan. It's absolutely vital to our family. We do still pay quite a bit in co-pays, but that is one of the reasons why I work.
Does it specifically state in her Blue Cross policy that they don't cover compounded or name brand drugs? If it does then they really don't cover it. If it doesn't state that then you could appeal it.Instead of having an individual plan just for her that doesn't seem to cover everything she needs, is there any way that your husband or you can get a job that does offer health insurance? In our case, my husband would never even consider a job that did not offer a health insurance plan. It's absolutely vital to our family. We do still pay quite a bit in co-pays, but that is one of the reasons why I work.
Does it specifically state in her Blue Cross policy that they don't cover compounded or name brand drugs? If it does then they really don't cover it. If it doesn't state that then you could appeal it.Instead of having an individual plan just for her that doesn't seem to cover everything she needs, is there any way that your husband or you can get a job that does offer health insurance? In our case, my husband would never even consider a job that did not offer a health insurance plan. It's absolutely vital to our family. We do still pay quite a bit in co-pays, but that is one of the reasons why I work.
Does it specifically state in her Blue Cross policy that they don't cover compounded or name brand drugs? If it does then they really don't cover it. If it doesn't state that then you could appeal it.<p>Instead of having an individual plan just for her that doesn't seem to cover everything she needs, is there any way that your husband or you can get a job that does offer health insurance? In our case, my husband would never even consider a job that did not offer a health insurance plan. It's absolutely vital to our family. We do still pay quite a bit in co-pays, but that is one of the reasons why I work.
DS has BCBS in a different state we're currently appealing a medication that is considered a non-formulary and a double whammy were told compounding isn't covered under our plan. The HR person and I tore apart our plan document and do not see ANY mention of compounding. BCBS claims as of August 2003 they consider compounding medications to be nonformulary. They were covering it for us until this past November. We have to pay 50% and a $15 copay instead of the usual 20%. And it doesn't matter once we reach our $1000 out of pocket maximum, we still have to pay a percentage on this med instead of "just a copay".
We filed for an exception based on medical necessity --- there is no replacement medication and were denied and told there is no further appeal process. We're still working on our appeal because how can they say there is no further appeal? Our doctor recently called to get the number of the medical director who denied it. Takes more of our time.
We filed for an exception based on medical necessity --- there is no replacement medication and were denied and told there is no further appeal process. We're still working on our appeal because how can they say there is no further appeal? Our doctor recently called to get the number of the medical director who denied it. Takes more of our time.
DS has BCBS in a different state we're currently appealing a medication that is considered a non-formulary and a double whammy were told compounding isn't covered under our plan. The HR person and I tore apart our plan document and do not see ANY mention of compounding. BCBS claims as of August 2003 they consider compounding medications to be nonformulary. They were covering it for us until this past November. We have to pay 50% and a $15 copay instead of the usual 20%. And it doesn't matter once we reach our $1000 out of pocket maximum, we still have to pay a percentage on this med instead of "just a copay".
We filed for an exception based on medical necessity --- there is no replacement medication and were denied and told there is no further appeal process. We're still working on our appeal because how can they say there is no further appeal? Our doctor recently called to get the number of the medical director who denied it. Takes more of our time.
We filed for an exception based on medical necessity --- there is no replacement medication and were denied and told there is no further appeal process. We're still working on our appeal because how can they say there is no further appeal? Our doctor recently called to get the number of the medical director who denied it. Takes more of our time.
DS has BCBS in a different state we're currently appealing a medication that is considered a non-formulary and a double whammy were told compounding isn't covered under our plan. The HR person and I tore apart our plan document and do not see ANY mention of compounding. BCBS claims as of August 2003 they consider compounding medications to be nonformulary. They were covering it for us until this past November. We have to pay 50% and a $15 copay instead of the usual 20%. And it doesn't matter once we reach our $1000 out of pocket maximum, we still have to pay a percentage on this med instead of "just a copay".
We filed for an exception based on medical necessity --- there is no replacement medication and were denied and told there is no further appeal process. We're still working on our appeal because how can they say there is no further appeal? Our doctor recently called to get the number of the medical director who denied it. Takes more of our time.
We filed for an exception based on medical necessity --- there is no replacement medication and were denied and told there is no further appeal process. We're still working on our appeal because how can they say there is no further appeal? Our doctor recently called to get the number of the medical director who denied it. Takes more of our time.
DS has BCBS in a different state we're currently appealing a medication that is considered a non-formulary and a double whammy were told compounding isn't covered under our plan. The HR person and I tore apart our plan document and do not see ANY mention of compounding. BCBS claims as of August 2003 they consider compounding medications to be nonformulary. They were covering it for us until this past November. We have to pay 50% and a $15 copay instead of the usual 20%. And it doesn't matter once we reach our $1000 out of pocket maximum, we still have to pay a percentage on this med instead of "just a copay".
We filed for an exception based on medical necessity --- there is no replacement medication and were denied and told there is no further appeal process. We're still working on our appeal because how can they say there is no further appeal? Our doctor recently called to get the number of the medical director who denied it. Takes more of our time.
We filed for an exception based on medical necessity --- there is no replacement medication and were denied and told there is no further appeal process. We're still working on our appeal because how can they say there is no further appeal? Our doctor recently called to get the number of the medical director who denied it. Takes more of our time.
DS has BCBS in a different state we're currently appealing a medication that is considered a non-formulary and a double whammy were told compounding isn't covered under our plan. The HR person and I tore apart our plan document and do not see ANY mention of compounding. BCBS claims as of August 2003 they consider compounding medications to be nonformulary. They were covering it for us until this past November. We have to pay 50% and a $15 copay instead of the usual 20%. And it doesn't matter once we reach our $1000 out of pocket maximum, we still have to pay a percentage on this med instead of "just a copay".
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<br />We filed for an exception based on medical necessity --- there is no replacement medication and were denied and told there is no further appeal process. We're still working on our appeal because how can they say there is no further appeal? Our doctor recently called to get the number of the medical director who denied it. Takes more of our time.
<br />
<br />We filed for an exception based on medical necessity --- there is no replacement medication and were denied and told there is no further appeal process. We're still working on our appeal because how can they say there is no further appeal? Our doctor recently called to get the number of the medical director who denied it. Takes more of our time.