Quote:
Originally Posted by netsavy006
I got something in the mail a few days ago, mentioning that there would be changes in prescription coverage starting Oct 2011, between Medicaid, Medicare, and managed care plans.
What I'd like to know is did anybody else get notice in the mail. I couldn't fully understand the letter, but it made it seem like medicaid would stop paying for drugs, and I'd have to use my managed care plan from now on.
Any other New Yorkers get anything in the mail. I don't fully understand the letter myself and would like to know if any other people know.
Thanks,
Andy
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I take it you havent been insured for medical coverage before with any insurance companies.
the short story about insurance companies is that every insurance company regardless of its name, state, private, insurance from the job .... whatever every insurance company decides which services they can offer their clients. Periodically the insurance companies review their plans and make changes so that they can continue to offer as many people as they can as many services that they can. Part of that reviewing is deciding what medications they will pay for, what type of doctors they will pay for, what services and lab work they will pay for, for their clients.
sometimes insurance companies have to make budget cuts on what services they can continue providing. they look at prices / costs of those services and how often those services are used by their clientèle as a whole.. all kinds of things go into insurance review processing. During this process they make a list of lab work, dental, vision, mental and physical services and medications that they will no longer cover.
once they make that list they mail out pamphlets, fliers and letters to their clients on their insurance plans to let them know of any changes they are making.
that letter was probably just to inform you of the changes so that if you are on any of those medications that are no longer going to be covered, you can contact your treatment providers and have a simular medication prescribed for you that is covered by the insurance plan.
suggestion - if there are any medications in that letter that you take and the letter says it wont be covered any longer, contact your treatment providers so they can prescribe something else that will help you, that is on the new list of covered medications. otherwise you will have to pay for that medication that is no longer covered by your insurance plan.
one of the joyful (Not) hassles with having insurance plans.. the meds you take may keep changing based on the insurance companies abilities to pay for those medications.
