aetna insurance, does it cover nexium, the purple pill?

  • Thread starter Thread starter marianne sickel
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I'm pretty sure there has been some kind of "study" done recently that says all PPIs are equally effective, because, starting last month mine and a friend's insurance has stopped paying for nexium until you try at least 2 other OTC PPIs. Even then, they only pay about 5% of the cost with comes out to about $300/month.

I really don't understand how an insurance company can over-ride what a Dr. has prescribed. I've been on Nexium for almost 2yrs. I've already been through the whole "let's try this drug" "ok that didn't work, let's try this one".

Now I get heartburn, which I haven't had in the past 5years, like I used to get in college.

As for aetna specifically? I'm not sure. Neither of our insurance is Aetna.
 
No insurance company will cover over the counter medicines...even though most OTC meRAB come in half prescription strength they also know that you can just take two or whatever to become a prescription strength. Remeraber insurance companies have doctors and a big staff of nurses reviewing claims and they keep up with the latest news on what is going on in the world of medicines and medical issues ...when science changes so do insurance companies.
 
My insurance (Atena) will let you buy any med you want but I do pay 50 bucks for it. I take 2 40 mg per day. They send me letters a lot suggesting Previcid, which would be 25 dollars but with my LPR, Nexium is supposed to be the best and this is what my Dr. prescribes. Can't say it got me well! I would think it would depend on what your company policy agreement shows. I work in HR and we do negotaiting with ins companies all the time so it could be a whole new set of rules.

CharBerry
 
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