Arriving to your visit with your provider, you discuss your health care and your provider suggest a possible medication that would meet your needs. Then writes a prescriptions and sends it over to the pharmacy.
Arriving at the pharmacy you find out that the pharmacy cannot fill the medication for you. They have it sitting there on the shelf but you cannot have it.
Look no future than your insurance. Many insurance companies have negotiated with companies and have formularies (a list of medications that are covered or not) and this allows the insurance company to provide coverage for reasonable rates. Insurance companies may send customers the formulary list in their welcome packet that is updated yearly. Keeping this handy for medical visits can prevent delays in getting your medications.
Should your provider had known before they prescribe? Often they do not because there are so many insurances and so many types that change yearly. Computer systems may not have this information when the provider prescribes because of laws regarding commercialization and trade. It is also very frustrating to providers when a medication is not covered. Often there may or not be a substituent or agreeable product that the patient can take.
Would a pre-authorization make a difference? Often not. If the insurance company does not have the medication on the list, it will decline a pre-authorization. A waste of time for the provider, staff, pharmacy, and wait for medication for the patient.
Future planning. If a particular medication is necessary or desired by the patient, choose an insurance plan that will cover this medication. Ask for the list of drugs/medications that the insurance covers before signing on. Then take the list with you to see your provider if there are any major changes with your medications.
About the Author: Lisa Goins PhD, APRN, FNP-BC, RMT is the CEO of Couture Health Care
Dr. Goins’ health articles are feature a mix of holistic health, wealth, and spiritual news, reviews, and information for health professionals and the public. Dr. Goins is the author of the newly released book CEO Business Objectives: Health, Wealth, and Success available for purchase on Amazon in the USA. Dr. Goins sees clients in Ohio, USA and can be found on Google+, Twitter, LinkedIn, Facebook, and Youtube Channe
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