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Twinzmommy2B
LIF Adolescent
Member since 12/10 580 total posts
Name:
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Twins and Health Insurance
Has anyone ever had this problem and what did you do about it...
Last week, my husband took one of our twins to the doctor only to find out that he had an ear infection. The doctor gave him a prescription for amoxicillin and we had it filled at a local pharmacy. It was covered under our plan. Yesterday, I had to bring my other twin to the doctor. Same thing...ear infection...given an RX for amoxicillin. I brought the RX to the same pharmacy and the pharmacist told me that it was too soon to fill the RX and did I have this filled somewhere else. I told him no...that my other son, who was born on the same day, had the same medication prescribed three days prior. He tried putting it through the insurance again and it was denied so I had to pay for it.
Both babies are listed separately on the card. Does this mean that if both kids get sick a few days apart and I need the same RX that it will only be covered once?? This is going to be a problem. I'm calling Empire on Monday.
Message edited 11/12/2011 8:53:15 AM.
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Posted 11/12/11 8:48 AM  |
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menmyboys
LIF Adolescent
Member since 5/11 811 total posts
Name:
Nikole
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Re: Twins and Health Insurance
What insurance do you have? Empire NYSHIP?? I would call their office. They are individual cases, individual coverages. This sounds like the pharmacy/insurance co were not communicating the information to one another... JMHO tho.
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| Posted 11/12/11 9:22 AM |
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sunflowerjesss
Mommy to 3!
Member since 10/05 20369 total posts
Name:
Jesss, duh.
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Re: Twins and Health Insurance
I had an issue when I was pregnant with a sono. The doctor did not list it was a twin pregnancy in the claim and therefore the insurance company tried saying the second sono on the same day was not medically necessary. The doc had to resubmit the claim properly and it got covered.
Sounds like a similar situation for you. I would call the insurance company yourself and explain they are twins. They should be able to tell you how it needs to be submitted.
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| Posted 11/12/11 9:32 AM |
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skinny
3 boys and a princess!
Member since 11/08 8178 total posts
Name:
Momma
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Re: Twins and Health Insurance
Never heard of that. Call your insurance or try a different pharmacy. Strange!!!!
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| Posted 11/12/11 11:04 AM |
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Arodisi
"My 3 Sons!"
Member since 3/06 3515 total posts
Name:
KT
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Re: Twins and Health Insurance
i have never had a problem either. i have emblem health/ghi.
def call your insurance co.
Message edited 11/12/2011 4:53:09 PM.
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| Posted 11/12/11 4:52 PM |
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jmf423
:)
Member since 5/05 6372 total posts
Name:
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Re: Twins and Health Insurance
Either your insurance co or the pharmacy messed up and doesn't have them separate. Def call the ins co to straighten it out!
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| Posted 11/13/11 8:03 AM |
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monkeybride
My Everything
Member since 5/05 20541 total posts
Name:
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Re: Twins and Health Insurance
The pharmacist should have called the insurance for you, NOT made you pay for it!!! 
This is a simple fix. The glitch is b/c they have the same birth date. Take your receipts back to the pharmacy and make them help you get your money back. Ugggh I'm a pharmacist and I freaking HATE lazy pharmacists who don't help people.
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| Posted 11/13/11 12:29 PM |
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