Advocating for Yourself

It used to be that you could count on your doctor to go to bat for you, and win, against the behemouth insurance companies, and anyone else who got between the doctor/patient duet.

No longer. Doctors try, but are hobbled by the demands HMO's and other insurance companies put on them. You're on your own now.

If your doctor prescribes a medication that is outside the insurance companies formulary, you're out of luck. They suggest other medications that are similar, cheaper, and that may not work.

One way to combat this may cost you a little. Say you need X medication for allergies, but the insurance company will pay for A or B brand. Have your doctor order A brand for you, the next month B brand, have the doctor document that both A and B brands did not work, and the only other option is X brand.

Magic! You'll get X brand, just a bit late.