This is topic Prior authorization and Mepron??? in forum Medical Questions at LymeNet Flash.

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Posted by lea (Member # 15593) on :
I was prescribed Mepron today, and I went to fill my prescription.

The pharmacist said that my insurance (BC/BS of CA) will not cover the Mepron without prior authorization.

They said they would fax my llmd the forms to fill out.

Has anyone run into this before?

What are my chances of getting the Mepron covered?

As a side note, I did test positive for babesia.
Posted by pab (Member # 904) on :
Our insurance didn't pay for Mepron when my kids were taking it. We paid out-of-pocket but it didn't take too long before we met our maximum out-of-pocket.

We have needed prior authorizations for other meds. Our insurance company faxes our doctor a form to fill out. There usually isn't a problem. Sometimes you have to try other meds first.

Good luck!

Posted by lea (Member # 15593) on :

I have already met my out of pocket max, so does that mean they are more likely to cover a medication?

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