I am about to go to new LLMD tomorrw and I was asked to bring my Blue Cross drug "formulary" (the ones that blue cross covers). the formulary seems rather small and rochephin / ceftriaxone is not on it at all.
Has anyone been on IV Rocephin through RI Blue Cross? And did they cover it? I am on the 3 tiered ($7, $30, $50) if that means anything in this.
I know my doc wants to put me on IV at some point and so now I am nervous.
Thank you, LD
Posted by Nancy2 (Member # 95) on :
Hi Luvdogs..... Another Rhode Islander here.
Rhode Island has a law that MANDATES that your insurance company pay for any treatments needed for Lyme Disease, regardless of the treatment or length of time needed. Feel free to go ahead without the fear of them denying you payment..
Best, Nancy
Posted by luvdogs (Member # 9507) on :
Thank you Nancy! I was aware of this law, but wasn't sure once I got my formulary. My LLMD told me today how lucky I wsa to live in RI bc of this law. he is a little confused about the formulary as well. He is going to look into it and clarify with BC before we start (next week PICC line). I am sure it will work out - just maybe a little red tape to work thorugh.
Posted by mookie (Member # 10403) on :
Did this law lapse or is it still in effect?
Also, if you come from another state, is the insurance company required to pay?
Posted by DW213 (Member # 9590) on :
Regardless of the law (which is great) you may be covered anyway.
I was on an injectible MS med (betaseron) even though the plan says injectibles are not covered.
Being self-employed, I have a really lousy direct-pay plan with BC/BS, and my deductible for this drug alone was $300. Painful, but still better than the $1500 retail.