Re: Venting on perscription costs (long)
From: Renee (anonymous@obgyn.net)
Mon, 09 Jul 2001 23:33:15 -0700
It was actually a Supreme Court ruling that a company (I think it was a drug
store chain) could not exclude prescription contraceptive devices (BCP, IUDs,
diaphragms), as that was discriminatory. Since it was the court, and not
congress, it only applies to that company specifically. However, it is
precedent for others to follow. You may want to check some news web sites to
find the details, and speak with your employer to ask for coverage (they
usually set the policies; eg: Catholic hospitals don't pay for BCPs since it's
against the theology), or talk to the insurance company.
When I changed insurances a few years ago, they didn't cover BCP. However, in
talking with them, it came up accidentally that it was for a medical
condition, not just contraception. Then, they told me that all I needed was a
letter from my physician stating that, and they would be covered. I did that,
and got them paid for. A few months later they changed their coverage policy
anyways, and paid for all women, not just special medical need.
Try the "medical necessity" approach. That often works.
Renee
Bronwyn De Forrest wrote:
>
> Renee,
>
> So....is it a federal law that birth control pills be covered now? I knew
> it was up for vote or something, but I wasn't sure if it was just Indiana or
> what. And, I had thought I heard it was turned down in Indiana....in
> essence, I'll be needing another note from my doctor to explain I take them
> for PCOS and to avoid another burst ovarian cyst requiring surgery to stop
> the internal bleeding.
> I'm confused about this now.
> Thanks for your help on this one!!!
>
> Oh....I'm just finishing up a "Legal Environment in Business" class. One of
> the other students wrote her paper about the McDonald's Coffee case. She
> said that once she got digging into the background information that wasn't
> brought into the highlight of the news, that it was much more than just a
> mere "ooops". I think she said that McDonalds had received many previous
> complaints about the coffee being too hot, the cups not sturdy enough, etc.
> I didn't read her paper but I thought it was interesting that maybe
> something most of us thought was a bit "much" could have had some solid
> basis for the action that was taken. Unfortunately,
> businesses....especially big corporations....are also guilty of not owning
> up to their responsibility to others until it's forced upon them by a
> lawsuit. Not taking a stand for or against anyone on this case, just
> mentioning that there are often things not stressed by the media that could
> have been strong reasons for results that we feel are a bit extreme.
>
> I do agree with you, though, about some of the stupidity on things people
> feel they must sue for!!! Sheesh....."the scar is too ugly"......What ever
> happened to laughing at things and going on with your life? (I have a
> "square" belly button due to all the surgeries I've had thru or running past
> it.......I think it's kinda funny.)
>
> Have a great day!
>
> Hugs,
>
> Shelley
>
> Renee wrote:
>
> ... the recent mandate for coverage of birth control pills (actually,
> > a Supreme Court ruling), and a few others. Mostly, it's state regulatory
> > agencies mandating what types of services must be covered in certain
> > conditions
> ******portions deleted to shorten original*****
> However, people do need to take some
> > responsibility for themselves. I spilled coffee on my bare legs once. It
> was
> > my fault. I wouldn't even think of suing McDonalds because they didn't
> tell
> > me coffee was hot. Doctors aren't perfect, though people expect them to
> be.
> > How many mistakes do other people make on their jobs. Unfortunately,
> doctor's
> > mistakes do affect a person's health. However, things will happen. Some
> > people will be allergic to a medication. No surgery is risk free.
> Sometimes,
> > people don't respond as expected. That is why informed consent is needed
> > before operations and procedures are done. (In case you're wondering, no,
> > I've never been sued. And, I have seen situations where I have suggested
> to a
> > patient that they may want to see an attorney. But, I have seen insane
> cases.
> > ie: a woman sueing a surgeon because the scar from her gallbladder
> surgery
> > was too "ugly." Even if the provider wins, or it gets settled or thrown
> out,
> > it's a lot of time away from work, and a lot of costs for the physician
> and
> > his insurance company.)
>
--
Renee Cordrey, MSPT, MPH, CWS
---
Don't follow in the footsteps of the masters. Seek what they sought.
--Zen saying
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