Home >> My mom's insurance doesnt cover her chantix, what options do I have?
My mom's insurance doesnt cover her chantix, what options do I have?
My mom is trying to quit smoking ( because she may have lung cancer ), and was given a trial of chantix, which seemed to help. However, my dad's insurance, Blue Cross/Blue Shield of IL ( though they live in WI ), apparently doesnt cover the medication for his particular plan. ( It's some quirky plan that just got switched over from a different insurance company. I dont think they have the option of selecting a different one because of the company they work for ).. Anyway, I've never heard of an Insurance Company these days not offering a "Quit Smoking Program".. Is there anyway to get this medication added to their formulary or something?
Thanks.
If your mother has a prescription she can still obtain it from the pharmacy. Here Chantix cost $140 for a 4 week supply and they recommend that you take it for 3 months but I didn't find it necessary to take for that long. My pharmacy said that there is not many insurance plans that cover this drug. The results far out weigh the cost. Good luck and best of health.
They need to have the dr write a letter or make a phone call on her behalf. Sometimes the insurance company will deny a patient a med at the pharmacy and then when we call the ins company, they'll approve it. It's worth a try.
If it's brand new, it can take a while. In the meantime, the best thing to do is ask the doctor for something that's been out a while longer, that IS formulary, that's maybe almost as good.
She can always look into purchasing it on-line. Sometimes you can get a discount that way or if you buy it in a 3 month supply.
Chances are it is not the insurance company that won't pay for it, but the employer that the insurance is through. Many of companies that offer health insurance are self funded, meaning they decide what is covered and what isn't. The insurance company is only administrating the policy(processing claims and answering questions to the members). The company themselves pays all of the medical costs. The companies have to write it into the contract if they want to cover smoking cessation services.