Has anyone with a moderate-severe heart condition been denied a medication by their insurance company?

My cardiologist prescribed a certain medication for my particular condition, and Aetna is attempting to force me to take a generic, cheaper med. (There isn't a generic for the prescribed one). They're also assigning me a "prevention specialist" nurse who is supposed to help me learn exercises and a diet that will supposedly wean me off most, if not all, my meds. I'm wondering if this is the norm for what's coming with the Affordable Healthcare Plan. I'm 75, I already exercise, have been through cardiac rehab, and I follow a cardiac diet. I feel like Big Brother is watching me.

ckm19562013-03-22T14:12:02Z

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You have to love the Insurance companies that think they know best. Remember one thing, they really only care about your health when it saves them money.

I'd ignore the "prevention specialist" and get your advice from your cardiologist. They want to "wean you" off your meds to save $$$.

As for the med in question, ask your cardiologist if the alternative is acceptable to him/her. If so, no problem. If not, Aetna has a process to appeal coverage denials. This basically involves your doctor stating why this particular med is needed.

Good luck.

?2016-12-15T05:54:44Z

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RE :Has anyone with a moderate-severe heart condition been denied a medication by their insurance company?
My cardiologist prescribed a certain medication for my particular condition, and Aetna is attempting to force me to take a generic, cheaper med. (There isn't a generic for the prescribed one). They're also assigning me a "prevention specialist" nurse who is supposed to help me learn exercises and a diet that will supposedly wean me off most, if not all, my meds. I'm wondering if this is the norm for what's coming with the Affordable Healthcare Plan. I'm 75, I already exercise, have been through cardiac rehab, and I follow a cardiac diet. I feel like Big Brother is watching me.
Follow 7 answers

Anonymous2016-08-30T03:38:43Z

I suggest that you try this web site where onel can get quotes from the best companies: http://INSUREFOREVERYBODY.INFO/index.html?src=2YAesgetUR02

RE :Has anyone with a moderate-severe heart condition been denied a medication by their insurance company?
My cardiologist prescribed a certain medication for my particular condition, and Aetna is attempting to force me to take a generic, cheaper med. (There isn't a generic for the prescribed one). They're also assigning me a "prevention specialist" nurse who is supposed to help me learn exercises and a diet that will supposedly wean me off most, if not all, my meds. I'm wondering if this is the norm for what's coming with the Affordable Healthcare Plan. I'm 75, I already exercise, have been through cardiac rehab, and I follow a cardiac diet. I feel like Big Brother is watching me.
Follow 7 answers

i_was_myself2013-03-22T05:12:24Z

Yes, I've had to pay for a few medication that my insurance company won't cover. As far as meds go, studies say american cardiac patients are often taking more than need amounts of medication. It isn't too surprising that an insurance company is combating this. However it is entirely the insurance company's doings. The new law has little to do with it.

Susan2016-07-25T20:38:28Z

I'm wondering why my providers won't prescribe the blood pressure medication I want to try. They say it's because of the insurance company but the insurance company tells me it won't be a problem. What is it, "never trust a patient", or what? I'd like to know the real reason.

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