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Insurance Denied Retin-A - Said I am too Old!
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MystyPines
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Tue Mar 24, 2009 1:29 pm      Reply with quote
This is too funny, so I had to post on it. I went for my 1st dermatologist appointment last week and the doctor prescribed Altria (Tretinoin). I went to the Pharmacy to fill the prescription and they said my insurance denied coverage because I am too old (age 44). I burst out laughing. I felt like saying, let me go to the insurance company so they can see all my pimples that I have been dealing with all my life! What a joke! So, the prescription is still at the pharmacy and waiting for my doctor to call them and see if they can straighten it out. What a joke!

Anyway, I thought it was amusing and wanted to share.

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Kassy_A
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Tue Mar 24, 2009 1:39 pm      Reply with quote
Just a little heads up here.. Next time you go, have the Derm write the script for TX of acne on your back.. (Insurance company's do not want to cough up payment for it for anti-aging purposes, but can't deny it for acne.)

If all else fails, I recommend alldaychemist.com

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♥I'm flattered by all the lovely PM's, but I don't get here much these days. Please don't be afraid to post your quearies to other DIY members who will be glad to help you (or sell you their wares..lol) Still happy with LED, dermarolling and a DIY antioxidant regime. Peace & Hugs to all.♥
averygsmom
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Tue Mar 24, 2009 2:36 pm      Reply with quote
Insurance pays for some of the strangest things, but not others. bestmedvalues.com is a good site to check prices on and I second alldaychemist. Also, there's inhousepharmacy.com, I ordered some RetinA without a prescription and it only cost me $37.
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Tue Mar 24, 2009 4:03 pm      Reply with quote
Laughing Laughing Laughing You're never too old!!! Laughing Laughing Let us know what happens!
ximing
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Tue Mar 24, 2009 4:15 pm      Reply with quote
That is funny. I would be angry if it happened to me. Let us know what's going on...
pinkberry
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Tue Mar 24, 2009 4:31 pm      Reply with quote
Age discrimination? I wonder if the insurance company had the written guidelines or its just at some staff's discretion.
Kassy_A
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Tue Mar 24, 2009 5:13 pm      Reply with quote
pinkberry wrote:
Age discrimination? I wonder if the insurance company had the written guidelines or its just at some staff's discretion.


Female, and an age of 35 plus is a red flag.. In my experience, back in the day, the only scripts I wrote, that were covered by insurance, indicated a firm DX of acne.

Also, the higher the %, the better your chances are of the insurance company covering it..... They are all too aware of this little miracle in a tube, and that the lower %'s are for anti-aging.

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♥I'm flattered by all the lovely PM's, but I don't get here much these days. Please don't be afraid to post your quearies to other DIY members who will be glad to help you (or sell you their wares..lol) Still happy with LED, dermarolling and a DIY antioxidant regime. Peace & Hugs to all.♥
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Tue Mar 24, 2009 8:54 pm      Reply with quote
wow that's too much, sorry about that. Crying or Very sad
Keliu
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Wed Mar 25, 2009 5:47 am      Reply with quote
How on earth can an insurance company dispute a script that your doctor has issued on your behalf for medical reasons. Sounds outrageous to me. In addition, I don't know why Retin-A is so expensive in the US - everywhere else in the world it seems to be fairly inexpensive.

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Wed Mar 25, 2009 6:47 am      Reply with quote
That's horrible! Retin-A works great for fine lines at our age. I get mine from inhousepharmacy.com. Great service and good prices, I've used them for all sorts of things for years, never had an issue.

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Wed Mar 25, 2009 4:41 pm      Reply with quote
Keliu wrote:
How on earth can an insurance company dispute a script that your doctor has issued on your behalf for medical reasons. Sounds outrageous to me. In addition, I don't know why Retin-A is so expensive in the US - everywhere else in the world it seems to be fairly inexpensive.
UK is also expensive. Obagi 0.05% Tretinon is 40 pound, 0.1% is £50. My friend bought a few tubes from China. It costs 15RMB only. Brick wall
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Wed Mar 25, 2009 4:42 pm      Reply with quote
Sorry, this repeat post is made by mistake.
milbader
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Wed Mar 25, 2009 5:28 pm      Reply with quote
Keliu: My insurance company originally denied my arthritis medication, Celebrex, and told me to take over the counter meds instead. I was at Walgreens when the pharmacy clerk told me that my prescription will not be filled. It was humiliating to say the least. My Dr had to contact them and give them details on all the medications I've used so far and other medical details. Finally, it was approved but it took a very long time.

This last week they denied DH the allergy medication, Allegra!! He still cannot fill the prescription and the Dr has given up trying to get it approved.

Seems topsy tervy to me to have the insurance company make the medical decisions.
iaimei
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Wed Mar 25, 2009 5:46 pm      Reply with quote
Or sometimes the insurance company just want your doctor to prescribe certain brands ie generic brands only.
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Wed Mar 25, 2009 6:02 pm      Reply with quote
iaimei wrote:
Or sometimes the insurance company just want your doctor to prescribe certain brands ie generic brands only.


The insurance companies just want to keep costs down so they can pass them on to........THEIR CEO's!!!!!

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Wed Mar 25, 2009 6:12 pm      Reply with quote
Insurance companies definitely run a lot of the stuff going on in the medical community. It's such a shame that in addition to knowing what they need to know to even be a doctor, they now have to know the ins & outs of all the different insurance companies & which company's formulary allows what...

This thread reminded me of when I had to be on birth control pills for medical reasons. I had emergency surgery that turned out to be endometriosis (after being told it was all in my head for almost a year!). I was put on Danazol (lovely drug - not!) for 9 months, and then told I had to stay on the Pill until I wanted to get pregnant. But the insurance company absolutely refused to pay for the Pill for any reason. Drove me nuts - especially years later when I found out that the insurance companies WERE covering V i a g r a! (Guess that word is a no-no.) Don't know if they still are, but wouldn't be surprised.

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Keliu
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Wed Mar 25, 2009 6:15 pm      Reply with quote
So what you're saying is that doctors are unable to prescribe the preferred medication to their patients because the insurance company can override their decision. What does the medical fraternity have to say about this? Seems absolutely crazy to me!

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lilmiss
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Wed Mar 25, 2009 7:36 pm      Reply with quote
Hello all -
I travel to Mexico for vacation at least once a year. You can get Retin-A in every strength as well as Tri-Luma at most of the pharmacy's. The cost is much less than the US as well. Whenever I go, I get orders from friends and come back with many, many tubes! Very Happy
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Wed Mar 25, 2009 7:39 pm      Reply with quote
Keliu wrote:
So what you're saying is that doctors are unable to prescribe the preferred medication to their patients because the insurance company can override their decision. What does the medical fraternity have to say about this? Seems absolutely crazy to me!


That's the American health care system in a nutshell. The insurance companies are running the show!
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Wed Mar 25, 2009 7:46 pm      Reply with quote
jom wrote:
That's the American health care system in a nutshell. The insurance companies are running the show!


I don't want to start a political discussion (because they're now not allowed) but does the new administration intend to reform this aspect of your health care system?

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jom
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Wed Mar 25, 2009 7:49 pm      Reply with quote
Keliu wrote:
jom wrote:
That's the American health care system in a nutshell. The insurance companies are running the show!


I don't want to start a political discussion (because they're now not allowed) but does the new administration intend to reform this aspect of your health care system?


I'll PM you
MystyPines
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Thu Mar 26, 2009 1:39 pm      Reply with quote
Hi Gals!

I called my Dermatologist about the situation on Monday, and her office told me that they had received a call from CVS Pharmacy about the denial of the prescription and the Derm's office said that they would take care of it and it would take 5 days to "clear." So, I am going to call the Pharmacy tomorrow and see if it cleared yet.

MystyPines

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MystyPines
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Fri Mar 27, 2009 1:02 pm      Reply with quote
Finally, after many phone calls to my Dermatologist and my Dermatologist to my Insurance carrier, my Atralin (Tretinoin) prescription was approved. It only took 5 days, LOL!

The price of Atralin is $152.00 a tube, but I pay $45.00. Wow, didn't realize this stuff was so expensive.

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pinkberry
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Fri Mar 27, 2009 5:04 pm      Reply with quote
Happy ending at last. Hope the drug work out for you too.
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Fri Mar 27, 2009 5:07 pm      Reply with quote
MystyPines wrote:
Finally, after many phone calls to my Dermatologist and my Dermatologist to my Insurance carrier, my Atralin (Tretinoin) prescription was approved. It only took 5 days, LOL!

The price of Atralin is $152.00 a tube, but I pay $45.00. Wow, didn't realize this stuff was so expensive.


The price of Retin-A in OZ is US$19.40, it's around the same price in Hong Kong. On the internet the price varies from $2.00 - $25.00 - something stinks somewhere doesn't it. If I were you I'd just purchase from the internet and stock up on the $2.00 Retin-A by buying a few tubes at once, thereby saving on postage.

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