if your doctor prescribes a medication shuould the insurace co. refuse to pay for it?

Answer 1

I think they should have to pay for anything the dr prescribes. Our insurance only pays for generics but my daughter has chronic serious ear infections and some of the antibiotics she has had to take don't usually come in generic. We've had to travel to different counties sometimes to find a pharmacy that would fill her prescription. I think they should have to cover the name brand since it wasn't readily available in our area. But obviously what we think doesn't matter in the least now does it?

Answer 2

some insurances yes the pharmacy can call the doctor to get a generic or prescribe something else. Some meds are new and cost more so insurance companies try to pay for brands that have been out awhile and cost less. My insurance comapny would not pay for the type of birth control my wife wanted she had to get something else

Answer 3

Some insurance companies have a cap on the amount they will pay for the drug if its really expensive or experimental. They also will limit the money paid out if its an illness that requires expensive drugs on a regular basis. If its something like birth control or antibiotics then no they probably wouldn't deny coverage...unless you have crappy insurance.

Answer 4

my insurance covers it but, there is a limit of the amount of pills i get if its very expensive drug
which im hating my medical insurance for that reason...
its a daily medicine that i need and they don't understand that
which the doctors told them that i need it every day and they still won't let me have any more than what they give me.
grrr

Answer 5

sometimes that can happen but the doctor should be able to proscribe medication in the same category that is covered by the insurance co