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Re: this is weird » raisinb

Posted by Glydin 3.9 on November 10, 2008, at 16:51:30

In reply to this is weird, posted by raisinb on November 10, 2008, at 15:57:21

> There is no generic equivalent, but the insurance company says it is a "non-preferred drug,"

~~~ That was my experience as the RX plan removed Lex from their formulary with the thought the generic Celexa was going to be acceptable. As I posted before, it has been returned for the 2009 list.

Yes, as a non-formulary med I had to have a form faxed from the doc's office for *any* coverage. Even at that, the coverage is nothing like it would be for a formulary med.

I would suggest you look into your plan. Brand names, generics, how a step plan is formulated - confusion reigns as to what makes the YEARLY list and what doesn't - with my plan it appears to have alot of variables. Some rationales are alright and others, grr producing.

Some plans have step programs where If there is evidence that a first step med was not effective the coverage may be better. It IS a hassle but sometimes worth it..... Plans will tell you "they" aren't going to tell your doc what to prescribe BUT, the bite is, they will decide what they will cover, the circumstances in which they will cover and to what degree they will cover it.


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poster:Glydin 3.9 thread:861904
URL: http://www.dr-bob.org/babble/20081106/msgs/862116.html