Today's word is "formulary"

[redbird]

Which is current insurance jargon for "we won't pay for the medicine you've been taking, you have to change to something cheaper."

So the friendly pharmacist called my doctor, and instead of Celexa I have something called Lexapro, which is supposed to be as good. I hope so. It will certainly be less convenient: the instructions read that I am to take "1/2 to 1 pill daily".

Comments

[elisem.livejournal.com]

Yeah. "Formulary" seems to equal "the generic."

There are cases in which one can get an exception. Generally, they involve trying the generic; if/when it does not perform adequately compared to the proprietary drug, one's doctor fills out a form stating that the patient in question ought to be given the name brand kind. The form goes to the insurance company, and the insurance company then informs the patient whether the exception has been granted or denied.

I've got a letter here which reads, in part:

"Your physician's Brand copay override request for Cylert has been reviewed by [BigInsuranceCompany] and [TheirBigInsuranceCompanyFriend].

According to the documentation provided by your physician the following outcome has been determined:

Granted

GRANTED COVERAGE EFFECTIVE [date] - [date] FOR [length of time] FOR THE BRAND PRODUCT AT THE FORMULARY COPAY LEVEL."

Which is a useful thing. The formulary type gave me extremely unpleasant results, and the brand name stuff works just fine.