Has anyone had any luck getting Blue Cross to pay for bicillin shots? We've just been denied coverage for it, and we've had to pay out of pocket for the second month. It's not cheap.
-------------------- Please consult your LLMD before making any changes to your treatment regimen. Posts: 641 | From NJ, USA | Registered: Oct 2001
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Don't know if this applies to Blue Cross... but when I started Bicillin (which I bought at my pharmacy and brought to my GP's office to have them do injections) the Bicillin wasn't covered on my pharmacy benefit, just because it wasn't one of the meds on their formulary list of covered drugs.
BUT someone at my insurance company told me that because this drug is administered in an MD's office, and the MD doesn't keep it in stock so I must buy and bring it myself, it will be covered under my regular MEDICAL benefit. They said I need to submit a claim with the pharmacy receipts and/or appeal, if needed, explaining this about the MDs office and it will be covered.
Hope that helps somebody.
Posts: 227 | From South of the North Pole | Registered: Jan 2007
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