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Q: Why won't my insurance company cover the medicine my doctor prescribed for me? A: Nearly all insurance companies have what is called a formulary. A formulary is a list of medications that an insurance company will cover. How this list is created depends on the insurance company. For example if there are 5 medications that all treat migraine headaches, an insurance company may decide to pay for only 1 of the 5 medications & typically the least expensive. There may be other reasons why one medication is on the formulary and other is not but the primary reason for any formulary is for cost containment reasons. Also worth mentioning is that many if not all of these same insurance companies are owned by pharmacy drug companies. Whether this impacts what medicine does get put on a formulary is debatable. |
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Last modified: March 30, 2007 |
