Meds, Mind, Body & Benefits > Insurance, Benefits Programs & HIV

Insurance companies that deny medications to patients.

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Ann:
I agree with Jeff. It's not unusual for an insurance company to question paying for a drug, particularly when that drug is being prescribed "off-label".

Just in case you don't know, drugs are approved for use in specific illnesses or conditions. When they're prescribed to deal with something they've not been approved for, it's called "off-label" prescribing. Many drugs are effective in situations they've not been approved for and so many drugs are prescribed off-label.

I take something off-label myself and I'm quite sure if I still lived in the US, my insurance company would probably be giving me grief over it. If you do not have Parkinson's but yet are taking a drug only approved for use in Parkinson's, then you're taking it off-label and that's why you're running into trouble with your insurance company.

Insurance companies have been doing this for a long, long time. Do I think it's right? No. I think it's positively criminal. If a doctor prescribes something for me off-label and it works, then I do not feel an insurance company should have the right to take it away from me.

This particular situation is one you can't blame on Obama.

bocker3:
While I am open to being wrong -- I believe that a Health Insurance company does have a right to your medical records.  They get it when doctors send in their charges -- they use specific codes that identify diagnosis -- so, I think your rant about them not having a right to your records is incorrect.

Mike

MitchMiller:
If you're talking about selegiline, I've been taking it for ten years, self-prescribed, to ward off dementia.  Studies demonstrated patients with dementia did not progress when on selegiline, although they also didn't get better.  You can get it from an overseas pharmacy for very cheap without a prescription, so you don't need to go through your insurance company.  I split the 5mg pill in three parts and take it six days/week.  Not sure if that might help you out.

vaboi:
I have to side with the insurance companies and the Affordable Care Act on this one.  Anyone who provides insurance, in my opinion, has the right to your medical records, if nothing else, in order to minimize fraud and abuse of the coverage.  I'd think that is what you are signing and agreeing to when you sign up for the policy.  If you do not agree to the terms and want to keep your conditions totally private, then you are perfectly welcome to pay out of pocket for your own prescriptions and medical expenses.  You do not HAVE to get medical insurance.  But if you do, there are terms you have to agree to.  It's just like car insurance.  State Farm isn't going to pay for a new bumper unless they can first inspect your car to see if the one on there is actually damaged.  lol   Same with health insurance.  The provider needs to know and confirm your conditions before paying for your drugs.  It's as simple as that.   And btw, if you live in the US, once you test positive, you are likely put in your state's database as having hiv, so your privacy is lost the moment that happens anyway.  So I don't know what your real problem is.   Do you think you really think you are going to see these attorneys or the judge again outside of the hearing where you need to testify or something?  lol  And if so.. who cares?  I'm sure they hear about all kinds of medical conditions day in and day out..

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