I agree that it is being done for the wrong reasons. The OTC drugs such as ibuprofen are high doses not available OTC and are used with different directions than OTC. You can't buy 600 or 800mg tablets over the counter. Insurance won't pay for the 200mg available OTC.
Some HMO's are better sighted than this, but many are not. I get rejections from various insurance companies for ridiculous reasons that will cost them in the long run on a daily basis. My own insurance plan now will not pay for physicals, but does have coverage for emergency visits. That doesn't really make sense financially in the long run, does it?
Mass health is one of the most difficult to deal with. They do not pay for OTC's period, unless the patient is a child. And then you have to have all sorts of special prior approvals which take tons of paperwork and time to do. I don't see them paying for this, which is sad because these are the people who can't afford meds anyhow.
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Some HMO's are better sighted than this, but many are not. I get rejections from various insurance companies for ridiculous reasons that will cost them in the long run on a daily basis. My own insurance plan now will not pay for physicals, but does have coverage for emergency visits. That doesn't really make sense financially in the long run, does it?
Mass health is one of the most difficult to deal with. They do not pay for OTC's period, unless the patient is a child. And then you have to have all sorts of special prior approvals which take tons of paperwork and time to do. I don't see them paying for this, which is sad because these are the people who can't afford meds anyhow.