Re: Insurance company rant
From: Anna Meenan, MD (annam@uic.edu)
Wed Dec 29 12:36:55 2004
Yes, I understand how formularies work, and I have no objection to
formularies (well, actually, I do, but that's a whole other topic), but
I object to the fact that Caremark sent me THREE separate formularies
without telling me which one to use for which patient, and then in the
fine print they tell me, essentially, Here are our lists, but just
because a drug appears on one of these lists, it doesn't mean we will
necessarily PAY for it. THAT'S what my rant was all about.
--
Anna Meenan, MD
At Wed, 29 Dec 2004, Allen, Christina R. wrote:
>
>If it isn't a formulary drug though, the patient doesn't get full
>benefit and has to pay out of pocket. So to prevent patients from
>cutting pills in quarters to stretch their supply, it's best to
>prescribe the alternative or covered generic as per insurance company.
>Pharmacists will catch this and give your office a call.
>Chris
>
>"How far you go in life depends on your being tender with the young,
>compassionate with the aged, sympathetic with the striving, and tolerant
>of the weak and strong, because someday in your life, you will have been
>all of these." - Author Unknown
>
>-----Original Message-----
>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of
>ainsron
>Sent: Wednesday, December 29, 2004 12:10 PM
>To: Multiple recipients of list OB-GYN-L
>Subject: Re: Insurance company rant
>
>When I get those types of booklets from insurance companies, they end up
>in
>the circular file next to my desk. I always write what I feel is
>indicated.
>If its not covered and the pharmacist can give me a similar alternative,
>I
>will change, but I'm not working for the insurance company, I'm working
>for
>the patient.
>
>Ronald E. Ainsworth
>
>-----Original Message-----
>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Anna
>Meenan, MD
>Sent: Monday, December 20, 2004 4:27 PM
>To: Multiple recipients of list OB-GYN-L
>Subject: Insurance company rant
>
>Sitting here at 6:15PM, finally reading my mail. From Caremark, i got a
>big envelope containing three booklets marked "Primary Drug List",
>"Preferred Drug List", and "Performance Drug List". Inside the first
>two brochures are the following statements :
>
>"Your specific benefit plan design may not cover certain categories,
>regardless of their appearance in this document", and "The drug list is
>not inclusive nor does it guarantee coverage, but represents a summary
>of prescription coverage". This second statement is also on the back of
>the third brochure.
>
>I have no idea what any of it means, or how it is to be used, or why
>there are three different booklets from the same company. You know
>what? I don't care. I'm going home.
>
>Anna Meenan, MD, FAAFP (which now stands for "Fellow of the Acadamy of
>Frustrated Physicians, I think)
>
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