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Meds no longer covered by insurance
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Scribble53128 posted:
I have been treated for ADD since 1980 and my daughter since 2000 so I'm not a newcomer when it comes to ADD, but apparently my insurance company is.

We switched to individual insurance in March 2011 with BCBS since our group health insurance at work was more than our mortgage ($1600 a month). Now we're on a high deductible with HSA and until now very pleased with the coverage. I went to fill my daughter's monthly Methylphenidate Rx and was told by the Target Pharmacist that ADD Medications are no longer covered by our plan as of the 1st of the year because it's considered mental treatment. I called BCBS and asked about additional coverage and the only thing that would cover it is their Premium (most expensive) plan. It seems silly to upgrade our plan when other than ADD treatment we are a very healthy family with no other health problems.

Are there other people out there experiencing the same thing? It would have been nice for the insurance company to let me know so that I can do research to find a new medication or coverage plan.

It's sad to think that now my daughter has to struggle in HS honors & AP classes and risk failing them because the insurance company feels that only the financial elite can succeed in school. I'm not going to increase my plan for a treatment that is cheaper than that for allergies.
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Gina Pera responded:
Was this exemption stated in your policy? I know it's a pain to compare policies but it's very important to do these days.

Some people don't want the more expensive policies because they don't need medication coverage.

Many of the cheaper policies limit medication coverage by making it subject to a deductible. Are you sure that's not what is happening?


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