S
stacycats
Guest
i have a condition called endometriosis. there are a few things you can do to treat this: have surgery (i did in 97), and/or take hormones most women use for contraception (i do this now). the hormones stop the advancement of the condition.
since depo-provera is usually intended for contraceptive purposes, my insurance hates to pay for it. they have made me jump through hoops to get it, every time i need the shot i hear another story about what needs to be done to get it covered. my dr has called and gotten prior authorization to get the medication 'coded' for medical rather than contraceptive reasons. six months ago, the insurance co made me stop getting the shot from the dr, they wanted me to pick it up at the pharmacy and bring it to the drs office myself. i believe this was so they could get their standard $10 co-pay for the medication. today, the insurance co has suddenly tripled my co-pay for this medication with no advanced warning. they refuse to give documentation to support this rate change. they said that since the medication lasts 3 months they want to charge me 3x the co-pay under this new rate schedule.
now, a tetanus shot lasts 10 years, do they charge you 10 years of co-payments?! i dont see why this situation should be any different. when i told the insurance company this, they said it was because i wasnt getting the shot from the dr, i was bringing it in. but they were the ones who said i had to do that in the first place!
is it discrimination to treat this shot differently from any other, and charge a co-pay for each month of the shots duration?
if necessary, are there non-profit orgs that would help with any legal battle, or lawyers would would work on comission? unfortunately i dont have the $$ to front for lawyers fees... i dont want to sue but i just cant deal with all the red tape anymore!
since depo-provera is usually intended for contraceptive purposes, my insurance hates to pay for it. they have made me jump through hoops to get it, every time i need the shot i hear another story about what needs to be done to get it covered. my dr has called and gotten prior authorization to get the medication 'coded' for medical rather than contraceptive reasons. six months ago, the insurance co made me stop getting the shot from the dr, they wanted me to pick it up at the pharmacy and bring it to the drs office myself. i believe this was so they could get their standard $10 co-pay for the medication. today, the insurance co has suddenly tripled my co-pay for this medication with no advanced warning. they refuse to give documentation to support this rate change. they said that since the medication lasts 3 months they want to charge me 3x the co-pay under this new rate schedule.
now, a tetanus shot lasts 10 years, do they charge you 10 years of co-payments?! i dont see why this situation should be any different. when i told the insurance company this, they said it was because i wasnt getting the shot from the dr, i was bringing it in. but they were the ones who said i had to do that in the first place!
is it discrimination to treat this shot differently from any other, and charge a co-pay for each month of the shots duration?
if necessary, are there non-profit orgs that would help with any legal battle, or lawyers would would work on comission? unfortunately i dont have the $$ to front for lawyers fees... i dont want to sue but i just cant deal with all the red tape anymore!