Prescriptions and Insurance
In addition to preparing for
questions at your next doctor visit,
there are also some caveats surrounding prescriptions and insurance that you may
want to be aware of should your doctor prescribe a prescription sleep aid.
Because there are many generic forms of brand name prescription drugs, insurance
companies and pharmacies may not always fill your doctor's prescription for you
as prescribed. Often times this depends on the cost of the drug prescribed and your
insurance company's policies. To help ensure that you get the prescription medication
your doctor intended, you may wish to get a better understanding of prescriptions
and insurance, and consider the following options.
Generic prescription medications
Primarily, insurance companies want you to try a generic medication first, because
they usually cost less. Typically pharmacists will follow these guidelines.
Generally, you first need to fill your prescription with the generic medication.
Once you have tried it and it has proven to be ineffective, you can contact your
healthcare provider and request the brand name medication. This process is called
a "step edit."
Prior authorization
In order to get some prescription medications, you may need your doctor to submit
a "Prior Authorization" form to your insurance company. Once you receive prior authorization,
contact your pharmacy to fill your prescription.
Consumer programs
There are some instances when your insurance company either offers a very high co-payment,
or simply won't cover a brand name prescription. In these cases, you may want to
check to see if the prescription drug has a consumer program, offering you savings
on your insurance co-pay.