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Question:

From Brooklyn, New York, USA:

The pharmacy where we have always patronized has recently decided to charge for syringes. My husband is taking Humalog and he needed the syringes in order to take the insulin. Are syringes covered by Medicaid any longer in NYC, and if so, why did the pharmacy decide to charge the full amount for these syringes? For me, personally, my husband needs the insulin in order to live. And, the syringes are solely used to provide the injections. Were they under law allowed to charge full price?

Answer:

Perhaps your local drug store no longer participates in Medicaid or perhaps your husband has a managed Medicaid program where he has to obtain his syringes from a particular mail order supply store. In NY State, there is a law that all insurance plans that provide prescription benefits must pay for diabetes supplies. It is not uncommon, however, for the plan to require that you obtain syringes and blood sugar testing equipment from a specific mail order company. If you go to a pharmacy that is not authorized to fill the prescription under your plan, they can still fill it if you pay full price. I would call the insurance company and ask how to obtain syringes through the plan. Do not ask IF the syringes are covered, just HOW to you obtain them through the plan. If you do not get an answer, contact the Attorney General's office (Eliot Spitzer) (see www.oag.state.ny.us. They are very helpful in dealing with insurance companies.

TGL

DTQ-20031206082655
Original posting 22 Dec 2003
Posted to Insurance/Costs

  
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Last Updated: Tuesday April 06, 2010 15:09:52
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