Patients sometimes experience confusion over whether their insurance company covers their medication. In case the patient is taking compounding medication, the patient and caregivers are even more confused. The long and short answer to this problem is this it depends on your insurance company.
Read the Insurance Company Tea Leaves:
Paying from Your Own Pocket:
Paying for medication from your own pocket can be frustrating. In the last couple of years, the price for making compounded medication like weight loss compounding medication, pain management compounding medication, etc. has increased significantly. In search of extra profit, suppliers have formed a cartel and forced the price of bulk powders and other key ingredients to go up. These charges ultimately are passed down to the patient. This reality can be painful for patients who need these essential compounded medications.
Understanding Coverage Issues on Compounded Medication:
Many of the insurance agencies have plans that cover compounded medications. The trouble takes place when the health insurance company determines which pharmacy is in its network for regular medicinal drugs and for compounded prescriptions. It is recommended to call your health insurance provider and get the list of pharmacies and ingredients covered for compounded medication.
Compounded Prescription Coverage Assistance:
Most of the Compounding pharmacies are very familiar with these scenarios and try to accommodate customers’ needs. Sometimes they’ll be capable of removing the ingredient in question which may not be covered under the insurance policy. Sometimes, they might even call your doctor and see if the non-covered ingredient can be replaced with some other ingredient that is covered by your health insurance plan.
Finally, your physician will be able to call your insurance company and talk with them on your behalf if you want the medication for the long term. This is called pre-approval. Determining whether or not your compounded medication is covered by your health insurance company is generally multi-faceted. It requires communication with your health insurer and may also involve talking with your physician and pharmacy. At Vios, we provide all assistance to our patients.
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