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View Full Version : An old familiar topic: Pre-authorization




Bobbi
09-22-2006, 12:12 AM
Mine (pre-auth. on pain med.) is due for "renewal" (is that what insurance calls it?). I saw my doctor today and she asked what she needs to do so that there isn't a prob. I was told, by H.R. personnel who got the authorization pushed through: Nothing... that I should tell her to do nothing at this time. The rationale? Sometimes things just ride on their own if no one brings it to attention that the pre-auth. is about to run its stated course.

Eeeeeeek. I am not comfy with this. My doc said she will do whatever she needs and she's okay waiting until she hears, otherwise, from me.

I don't want to "rock the boat" (H.R. and CEO who went to bat all the way for my medications and got them authorized) as long as I'm being told not to do so, but... I also have this fear that... what if I end up with having to go through everything again?

The H.R. assures: Not gonna happen. It and the CEO will jump on it quickly if things start going a diff. direction.

Anyone else been through this?

I'm just at a loss. I want to so much trust that they are right.




ejbpesca
09-22-2006, 10:12 AM
In my situation once a drug is preauthorized that's it..no more authorization needed. I am going through that with BP med right now. The insurance co. wanted me to try and old cheap drug first before they would allow coverage on a new expensive drug. It was all a surprise when I went to get the newer drug filled and the pharmacist said it was not covered by Express-Scripts. The doc did not know of this situation either but after many calls and explanations he caught on. My trial period is over and now I may use the newer drug.

Now..Express-Scripts had provided a website for its members so they can check what is covered and what is not covered. Extensive lists of various meds are posted with pricing.

In some cases like Xanax there is 0 coverage but if you use a cheaper drug almost identicle to Xanax it is covered.
jb

snoozie
09-22-2006, 10:49 AM
I just went through this yesterday with express scripts. When I went to get my pain med filled they told me it needed to be pre authorized. This is the first time this has happened. I usually don't take as many as I am prescribed so I don't have the worry about running out but it sure is a hassle to call doc and get this done. Just one more hoop to jump through I guess...SUe

shotspine
09-22-2006, 05:55 PM
I've been sicker than a dog this whole week trying to conform to Pre-Authorization for Lidoderm Patches. They sent my Dr. a list of 4 meds I have to try before they authorize the Lidoderm. I'm so stinking furious for having to suffer like this taking meds that have nothing to do with the patch I want/need. Being very med sensitive to start with, this is going to be a long long haul.

My best wishes for everyone having to deal with this.