Hi Bob:

I once remember having a conversation with one of my insurance reps on the phone about a prescription drug I was supposed to take. They had changed it from a name brand to a formulary (whatever the heck that meant). What it meant for ME, was it would be costing me $58 instead of $28 as a co-pay. I then told the rep on the phone, "I'm on disability, I need this drug, and I can't afford to pay the new price".

This is exactly what she told me. Now I have no idea if this can apply to you but it's worth a shot. She said:


"If your doctor writes a letter stating that you must be on this drug and that you can't take any other drug for your medical problem, then the insurance company HAS to give you the drug at the former price".

I just said to her "are you kidding me"? she said "No, this is done all the time but no one knows that they have to get their doctor involved and that their doctor has to write letters". "It goes to our medical management department and they review it and often (when they realize that YOU HAVE TO HAVE THIS PARTICULAR DRUG), they change the status of the drug down from the forumulary to the name brand and it's covered under the cheaper price"

Never knew this before.

Now this was a few years ago. I was in the process of changing my medicare advantage insurance plans so my new plan covered whatever the heck the drug was at the time (I'm 59 and don't remember anything anymore).

But you really have nothing to lose. To save a few bucks here and there and if you check with your insurance and they say to get a doctor's note, well, why not see if this is the way you can go.

I truly wish you luck in doing this. Sometimes it works, sometimes it doesn't.

Honestly, I find that sometimes it's WHO you get on the phone that matters, not the policy.

For example. I have a sattellite tv. I do not get Showtime or any premium channels because I can't afford them so if I want to see a clear tv picture I have to subscribe to basic cable.

There was something on Starz once and it would cost me $10 a month to subscribe to Starz. I simply called up the cable people and politely asked them if they could add on Starz so I could see the show I wanted. I explained my financial situation, I explained that my husband was on disability, did not drive any more we really don't get to go out very much, we don't go on vacations and all we really have is tv (and this is all true by the way), and there was this one show, so could she find it in her heart to do whatever they do to add on a premium channel and could she please do this for me.

This is exactly what happened when I asked her that. (Oh before I continue, let me explain what happens when they add a channel. They are in front of a computer system and all they have to do is press a button. Thats it. I know this because I watched a tv special on cable tv once. So I knew that the person I was speaking on the phone to at the time had it in her power to do exactly what I was asking her to do. BUT she didnt know that I knew this.

So after I politely asked her if she could give me the Starz fchannel for a few days she replies to me "Oh no, it's not in my power to do this, I can't do that, I'm so sorry". I then respond: "Oh, it's so kind of you to take to time to at least talk to me, my husband is disabled and I just wanted him to see his favorite movie, but I completely understand, and I thank you for your time".

Two seconds go by and she goes: "Welllllllllll, let me see what I can do".

Five minutes later, there was the Starz channel on my tv along with the other channels that come along with Starz, about 8 in all. All premium channels. I pretended to be in awe saying "oh my god, how did you do that, you are awesome and I appreciate what you did, my husband will be thrilled".

She said "I'm giving it to you for three months for free". I was flabbergasted.
I only thought I'd get it for a week or so.

THAT WAS REALLY SOMETHING. I learned then (as it applies to cable tv, I mean), it's how you ask for something and how you respond when you get it. My father taught me that years ago.

Oh by the way, I've been getting Starz, and showtime for FREE for over a year now. When the three months of one are up, I simply call and politely ask if they can extend it and that I would be very appreciative. Since it's only the push of a button, they are always gracious and now we can see showtime and Starz and (The Movie Channel too).

Now I have a friend who tried to do this. She called them up and asked and they said no we can't and she said thanks and hung up. I just shook my head.

So go and ask the insurance people if you get a note from your doctor detailing that you MUST be on this particular drug might this make a dent in their decision???

And if anybody reading this gets added cable stations, well, why not!!!!

Love, Melody