Does it make sense to pay for prescriptions myself then file a drug claim form with insurance? Will it still apply towards my deductible?

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I’m going through IVF. I recently switched insurances to BCBS of NC. WITHOUT insurance, I was quoted $2600. WITH insurance, I was quoted $4200 🙄

I have a combined health and prescription deductible of $3500. 0% co-insurance after the deductible is met. However, my prescriptions I am using have a lifetime max, which I will meet on 1 out of the 4 drugs with just this 1 round of IVF with 1 more round to go. 1 of the drugs that cost $700 requires prior authorization, but just reading through the information, I’m pessimistic about the insurance company approving this.

So my thought was to pay the $2600 WITHOUT insurance, then file the drug claim form for the medications. Then have that apply towards my deductible (possibly excluding the prior authorized drug,so maybe -$700). I’m not sure if that is how it works? Or if that is the best solution.

I’ve been trying to do the math and it’s all so confusing with these lifetime maxs.

I’ve been on the phone with the insurance company 5 times over these past 2 days and I can’t seem to get clear answers. It’s so frustrating

submitted by /u/MrsAllieCat
[link] [comments]
I’m going through IVF. I recently switched insurances to BCBS of NC. WITHOUT insurance, I was quoted $2600. WITH insurance, I was quoted $4200 🙄 I have a combined health and prescription deductible of $3500. 0% co-insurance after the deductible is met. However, my prescriptions I am using have a lifetime max, which I will meet on 1 out of the 4 drugs with just this 1 round of IVF with 1 more round to go. 1 of the drugs that cost $700 requires prior authorization, but just reading through the information, I’m pessimistic about the insurance company approving this. So my thought was to pay the $2600 WITHOUT insurance, then file the drug claim form for the medications. Then have that apply towards my deductible (possibly excluding the prior authorized drug,so maybe -$700). I’m not sure if that is how it works? Or if that is the best solution. I’ve been trying to do the math and it’s all so confusing with these lifetime maxs. I’ve been on the phone with the insurance company 5 times over these past 2 days and I can’t seem to get clear answers. It’s so frustrating
submitted by /u/MrsAllieCat [link] [comments]Read Morer/HealthInsurance

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