Articles

Trying to navigate the cold, confusing health insurance maze

If you are young and on medication, and the approval of your peers is your life nutrient, then an unsightly side-effect — in this case, drooling — is unacceptable. Fortunately, there is a common and generic treatment; according to GoodRX, it costs $23 a month. I phoned it into the patient’s pharmacy.

A day later, the pharmacy called: Insurance had rejected the claim. I called the insurance line and spoke to a pleasant representative. She explained that my patient would need to try three other medications for peptic ulcer disease first.

The patient didn’t have peptic ulcer disease; she had schizophrenia. Salivation was a side-effect of the only drug that had helped her. I filled out a Prior Authorization form with details.Read the entire article on The Boston Globe