It’s common for caregivers and patients to be confused over whether or not their medications are covered by insurance companies, especially where compounded medications are concerned. There is no easy answer to this since it really depends on your insurance coverage. However, it is important to understand that there is no blanket ban on compounded medications being covered by insurance carriers.
American Integrative Pharmacy (AIP), led by the diligent Dr. Neema Yazdanpanah, provides safe and proven compounding medications to patients in Long Beach, Torrance, Los Angeles, South Bay Orange County, Redondo Beach, Palos Verdes, Southern California areas, and online nationwide.
Reading the Fine Print
There are a few insurance carriers that cover compounded medications as long as certain conditions are met. There are other insurance companies that don’t cover compounded medications at all. You would only be able to use generic or brand formulations unless you are prepared to pay out of pocket.
You should get in touch with your insurance company and explain your particular situation if you need a particular delivery method of specific formulation. There are several different delivery methods, such as patch, liquid, and melt tab in compounded medications. Based on this, you should let the insurance carrier know if you are supposed to be taking the medication long-term.
Typically, such cases are determined on individual basis. You may just be able to obtain coverage for your compounded prescriptions.
Issues with Compounded Medication Insurance Coverage
Your insurance company may provide coverage for compounded prescriptions. In relation to this, they will require the pharmacy to be part of the network. You may be able to get your prescription filled from an out of network pharmacy by paying a bit more. Problem occurs when a pharmacy is determined to be in network for regular medications, but out of network where compounded prescriptions are concerned.
Things can become even more convoluted when the pharmacy is in network for both compounded and traditional medicines, but the insurance carrier refuses to cover the prescription. This occurs if any ingredient in the compounded medication is not covered by the insurance company. They will most likely reject the entire prescription for drug coverage. This makes it necessary to cover all bases before submitting a prescription.
Coverage Assistance by Insurance Companies for Compounded Prescriptions
Compounding pharmacies are familiar with the different issues concerning insurance coverage. They try their best to accommodate the needs of their customers. In some cases, they may be able to remove an ingredient that is not covered by the insurance carrier. They may go so far as to call the physician to get a non-covered ingredient switched.
Your doctor may call the insurance carrier to speak on your behalf for obtaining coverage if the medication is going to be for long-term. This is also known as pre-approval. The compounding pharmacy may help in this regard as well. They may fill a Universal Claim with the insurance company that may gain approval for the compounded medications.
It can be difficult to determine whether a compounded medication is covered by the insurance company. AIP provides advanced compounding pharmacy solutions, including online prescription refills to patients in Long Beach, Torrance, Los Angeles, South Bay Orange County, Redondo Beach, Palos Verdes, Southern California areas, and online nationwide.
California Pharmacy’s Online Compound Prescriptions
American Integrative Pharmacy is located in Torrance, CA serving residents in and around Orange County, Los Angeles, Long Beach, Lomita and surrounding areas. Online prescription sales are available across the US.