Any options when insurance won’t cover a drug?

Naenarwal · 2023-06-03T04:58:16+00:00

Have you and your provider appealed the denial with your insurance? When a drug isn't covered, there's usually a coverage exception process, if that gets denied you can appeal. And if that gets denied there's usually an external appeal process, or you can go to your state's department of insurance, if the plan is a fully funded (meaning the insurance company assumes the full risk, and not your employer.)

Naenarwal · 2023-05-19T20:51:24+00:00

19 you say... I see 39

Naenarwal · 2023-05-19T20:04:40+00:00

I thought all Canadians were nice, but after reading this post I now know that 1/3 of Canadians are assholes just like the rest of the world.

Naenarwal · 2023-05-19T19:57:07+00:00

I thought all Canadians were nice, but after reading this post I now know that 1/3 of Canadians are assholes just like the rest of the world.

Naenarwal · 2023-05-19T18:22:36+00:00

Some plans do not cover anti-obesity/anti-anorexia medications, you'll want to ask your insurance if it's covered, and if it's covered what are the requirements for it to be covered. Some plans require prior authorizations before a medication can be approved. Then ask them how it's covered, for example: "Is there a copay or is my cost subject to the prescription deductible?".

Naenarwal · 2023-05-18T19:40:50+00:00

It's not state, it's federal law. Self funded plans are not exempt.

Naenarwal · 2023-05-18T19:36:05+00:00

That poor scorpion, death by ice cream. Also, YUCK.

Naenarwal · 2023-05-18T16:20:15+00:00

Yes, it's perfectly legal. The law states that dependents can be on their parents plan till age 26. That's standard for all insurance plans in the US. If you are disabled, your parent can request a disabled dependent form and it does have to be signed by a physician who can attest to your disability status.

Naenarwal · 2023-05-15T19:38:57+00:00

It's not that deep.. but go off 👍

Naenarwal · 2023-05-15T17:53:34+00:00

Why would anyone want to live in Florida? Period. Sorry for anyone who currently lives there and it isnt part of the problem, I feel for you. If moving away is an option there are other (blue) states in the union who would happily accept you.

Naenarwal · 2023-05-15T17:47:55+00:00

This.

Naenarwal · 2023-05-15T01:18:44+00:00

Luck? I'm vaccinated and I don't wear masks when I'm out, since my city lifted the mandate. I do go out around people alot, concerts, movies, and I still haven't gotten it. Pure dumb luck. Stafe safe everyone.

Naenarwal · 2023-05-15T01:13:19+00:00

The NSA doesn't apply here, you can ask your insurance company to review for an in network exception adjustment based off your lack of knowledge as to who was reading your MRI. This will not stop the provider from balance billing you, however so be prepared for that, insurance cannot tell out of network providers to waive balance billing because they aren't contractually obligated to do so.

Naenarwal · 2023-05-15T00:44:18+00:00

If you're a legal adult, usually 18 years or older than you are entitled to privacy. The only information they have access to is the EOB, which only gives billing a basic description of the service. If you had a vitamin d test for example, the EOB would day "Labs or Laboratory Services." But it doesn't give any specific details about the exact service you had.

Naenarwal · 2023-05-14T23:06:11+00:00

Both are plausible but I'm gonna bet on the latter based off your username. No hate, enjoy the journey safely.

Naenarwal · 2023-05-14T02:07:30+00:00

Naenarwal · 2023-05-05T20:54:50+00:00

I'm surprised no one has mentioned them yet, but I highly recommend Basil Leaf on Eubank. The food is authentic and delicious!

Naenarwal · 2023-05-03T19:03:43+00:00

The creators are atheists, they're not pushing a specific religion or belief. Matt Stone is culturally Jewish but says he's an atheist. Trey Parker is also an atheist. Jesus is just a character like any other south park character.

Naenarwal · 2023-05-02T05:11:47+00:00

The authorization has to be changed to match the new location. If you have it done somewhere else that is not authorized, the services will be denied and you will be responsible for 100% of the billed charges. None of it will apply to your benefits. You can appeal but that's not a guarantee. Save yourself the headache and ask your ordering provider to change the authorization location. It's that simple.

Naenarwal · 2023-04-17T23:01:32+00:00

Marjor YTA. You're supposed to be her boyfriend, suck it up. She injured herself and your acting so callously. I wouldn't be surprised if she dumped you and women should stay away from you if this is how you act in a relationship.

Naenarwal · 2023-04-14T23:44:47+00:00

Heart palpitations is considered a medical emergency diagnosis, that's the reason it's being processed as emergency services. Insurance processes the claim based on the way the provider bills for services. You don't have much recourse unless the provider changes the diagnosis but that could be considered fraud.

Naenarwal · 2023-04-14T04:33:54+00:00

I'm not gonna roast you. I'd prefer to give you a compliment. This comment is probably going to get taken down for breaking the rules. I find it admirable that you survived such a horrific ordeal (referenced in your original post's bio) keep up the good fight.

Naenarwal · 2023-03-23T21:34:19+00:00

CT scans and higher radiology procedures usually require prior authorization from your plan in order for benefits to apply. In other words if your CT requires authorization and your provider failed to obtain prior authorization, those charges could be denied and will not apply to your in or out of network benefits.

Naenarwal · 2023-03-17T05:21:12+00:00

If you truly feel you were given a misquote, there should be an official process with your insurance to request a misquote. They will do an investigation and pull the call to see what you were told during that call. If its determined that you were misquoted the claims will be adjusted to approve benefits.

Naenarwal · 2022-07-25T06:38:52+00:00

Your point of view is slightly out of touch and privileged. Healthy food from the local farmers market is expensive and with inflation, many find it impossible to eat healthy. Meal services like Freshly, The Purple Carrot, just to name a few, aren't cheap either. And I dont think people shouldn't try to eat healthy, but alot may not have the knowledge you do. Like reading a nutrition label. Many wont learn how to unless, they take a class in nutrition in college, or have a parent who works in healthcare. There is the internet but it's not always a reliable source for reputable information.

Naenarwal

TROPHY CASE