Can my insurance company covers zero of the only medicine I have ever been prescribed to control my asthma?
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Can my insurance company covers zero of the only medicine I have ever been prescribed to control my asthma?
The last 3 years I have been asthma free thankfully and have not needed an albuterol inhaler hardly at all. This past week I came down with bronchitis and was prescribed to use the medicine again. Although I have not had symptoms the past 3 years because I have had asthma attacks in the past my doctor like me to have one always just in case of emergency. New Link Destination
day I went to the pharmacy and was informed that provider actually covers not 1 cent of that medicine which they had never seen before. I work hard and try not to complain so this is hard for me but it just seems so unethical. How this can be a legal practice?
Asked on November 29, 2018 under Insurance Law, California
Answers:
SJZ, Member, New York Bar / FreeAdvice Contributing Attorney
Answered 5 years ago | Contributor
An insurance, including health insurance, policy, is a contract. The insurer has to pay for those things or medicines, and only those things or medicines, which the terms of the policy and any attached schedules require then to cover. Ask the insurer to explain why they believe they do not have to cover this medicine and provide any supporting documentation; if you disagree with their assertion, contact your state's department of insurance to inquire into filing a complaint.
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