How can I find a health insurance provider that will cover costs for getting Accutane?
Hi, I hаνе never bουght health insurance before, аnd I wουld lіkе tο know hοw I сουld find out іf a particular health insurance provider wουld cover thе costs οf mе going tο a dermatologist аnd getting Accutane. Cаn anyone hеlр mе?
Humana offers an individual plan in which you would pay a $50.00
copay for this drug if you are approved and no limitations are provided by underwriting department.
You will have to admit during application you have acne, though
http://apps.humana.com/prescription_benefits_and_services/execreq.asp?processcode=3&srcsite=home&productid=4&ndc=00004016949
Also, this plan is not available in all states.
That could be a difficult task, asides from sitting there and calling all the insurance plans around you can try contacting the company that makes it and see if it is one of the medications the patient assistance program covers.
http://www.rocheusa.com/programs/patientassist.asp
Because that’s a risky and costly procedure, it may not be easy. Check the websites of the insurers – most of the big ones have them, and look at their formulary. (It’s a list of all the drugs they cover and if it’s preferred, it’s cheaper, if it’s not preferred, you’re going to spend top dollar.)
If it’s not a covered thing, you might able to prove medical necessity with help of your PCP and the derm. It’s not a guarantee, because if something is not covered by a plan, you can’t force them to cover it. You can show them it’d be cheaper in the long run if they cover it and hope for the best.
Good luck.
I have read several places that a full course of Accutane treatment costs around $3,000 but that is just from random Web browsing, and I would imagine that the course you take depends on the severity of your condition and how well your respond to treatment. A couple of cautionary observations before I go on, though. First, Accutane is a “last resort” acne treatment because of its potentially severe side effects, so make sure you really need to take something like this. Second, a personal side note: I dated a girl who took Accutane and it made her very, very depressed.
It’s always been my opinion that before you think about how to pay for a medical cost, you need to choose who will take care of you, what treatment is needed, and go from there. Pick out a dermatologist you trust and ask them about plans they participate in and about costs. Then comparison shop for different plans until you find one that you like. Accutane is covered by many different insurance companies, so that should not be a problem, as long as your doctor says you need the treatment.
Try MostChoice.com. You can quickly compare plans and talk with multiple state-licensed health insurance agents without any pressure to buy anything from anyone. But first I would find out who you want to treat you because that will affect your choice of health plan; you’ll want to be sure that your health care provider participates with the health insurance you end up buying.
You can visit MostChoice here: http://www.mostchoice.com/health-insurance.cfm
I’ve included a couple of links to Web sites about acne and Accutane. I thought the community there might be a little more useful for you than this general forum.
Hope this helps,
Barnes@MostChoice