Question: What Happens To My Prescriptions When My Insurance Changes?

How do insurance companies decide which drugs to cover?

Insurers and other payers look first at how well the drug works — not its cost — when they decide whether to cover the latest treatments, according to the nation’s largest pharmacy benefits manager, Express Scripts..

Why is my medication not covered by insurance?

In most cases, your doctor won’t know every medication covered under your insurance plan’s formulary and could write a prescription for something not covered. There are simply too many different health plans. Check your plan’s website or call your plan for a full list of covered medications.

Can I fill a prescription without using my insurance?

If you find yourself uninsured or underinsured (meaning not all your medications are covered) you can always fill your prescriptions at any pharmacy and pay cash or use a discount drug card to help reduce your prescription medication costs.

Will my insurance tell my parents?

Insurance companies send summaries of recent services to their policyholders. That means if you visit a clinic, get an exam, or get a prescription for birth control, it’ll be sent in the regular policy communications your parent gets, or available online if your parent manages their policy electronically.

What is a Tier 2 prescription drug?

Tier 2. The prescription drug tier which consists of medium-cost prescription drugs, most are generic, and some brand-name prescription drugs. Tier 3. The prescription drug tier which consists of higher-cost prescription drugs, most are brand-name prescription drugs, and some are specialty drugs.

Can I go to Planned Parenthood without my parents?

You don’t need to be accompanied by an adult to visit a Planned Parenthood health center. You can just go by yourself. Find your nearest health center and make an appointment.

Do prescriptions show up on insurance?

EOBs are the documents your insurance company sends out that show the basic information about anything your plan helped cover during that statement period, from prescription costs to hospital payments.

What if my prescription is not covered?

If your insurance doesn’t cover your medication, there are a few alternative options to explore. You can ask your doctor for an ‘exception’ based on medical necessity, request a different medication from your doctor which is covered by your insurance, pay for the medication yourself, or file a written formal appeal.

Will my parents know if I go to Planned Parenthood?

Will my parents need to know I visited Planned Parenthood? Our health centers provide confidential services, so your parents do not have to know that you came.

Can I go on birth control without my parents knowing?

Yes. You do not need permission from a parent or guardian to get birth control. In fact, it is unethical and illegal for clinic workers or health care providers to tell your parents/guardians you were even at the clinic. The agreement to keep your visit private is called a confidentiality agreement.

How do I get my insurance prescription approved?

Prior authorization works like this:Step 1: Your pharmacy will contact if your doctor if he or she did not obtain prior authorization from the insurance company when prescribing a medication.Step 2: The physician will contact the insurance company and submit a formal authorization request.More items…•

How do I get my insurance company to pay for brand name drugs?

File an Appeal. You and your doctor can either complete and file an appeals form provided by your insurer, or write a letter that includes the name of the drug, why you need it covered, and any other supporting documents from your doctor. Your insurer’s website will provide more details on the appeals process.