Does your doctor's office determine if your health plan will cover a given prescription?

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  • Ethel - 12 years ago

    Does your doctor's office determine if your health plan will cover a given prescription? The answer to this No....You only find out if it's cover when you go too the Pharmacy and your script is input to the Ins. Co...They are the ones that tell you if your Meds are covered or not...Also the Ins Co put the price on the Meds not the Pharmacy. Yes some Pharmacy have what would be call a hidden cost but you'll never know it as you have a Co payment and that is what you pay.. The only time the Dr gets invold is when the Ins Co will not cover the Med and the Pharmacy must get prier approval....Then the script is faxed back too the Drs office and they must sign off on this request and this is sent back too the pharmacy. This can take some time too get that approval as again the Dr's or his office personal have very little to do with your script after it is given to you or E script or faxed or called into the pharmacy. So if you want your Meds you will have to keep after the Dr and call the pharmacy to see if it's approved.

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