[scarlett68]

I am starting work for the State of FL and am looking at my healthcare options.

Can anyone with the United Health Care HMO through the state tell me what the "supply limit" (SL) for certain drugs means on their prescription coverage? I take several of the medications they say SL about, and I am wondering if I sign up, will they cut off my medication?

Does SL mean they get to decide about the number I take per year, or whether I should be taking them at all, or is it just a "prior authorization" type situation, where the doctor just needs to fill something out explaining why I need them?

Thanks

[iuki001]

Originally Posted by scarlett68

I am starting work for the State of FL and am looking at my healthcare options.

Can anyone with the United Health Care HMO through the state tell me what the "supply limit" (SL) for certain drugs means on their prescription coverage? I take several of the medications they say SL about, and I am wondering if I sign up, will they cut off my medication?

Does SL mean they get to decide about the number I take per year, or whether I should be taking them at all, or is it just a "prior authorization" type situation, where the doctor just needs to fill something out explaining why I need them?

Thanks

Your best bet would be to call the insurance company directly and ask them any questions you have. We relocated here from a state where we had an HMO (which we loved). I am a retired Federal employee, and there is no HMO plan offered to us in Clermont, FL. Definitely call the insurance company and let them know your zip code where you will be living and write yourself a list of questions before you call them.

You definitely want to get the correct information "first hand" rather than from another source.

Best of Luck and Welcome to Florida.

iuki

[scarlett68]

Thanks. I tried that but they didn't give me any info. They said they didn't have any info to give at the moment, which I thought was strange.

[iuki001]

Originally Posted by scarlett68

Thanks. I tried that but they didn't give me any info. They said they didn't have any info to give at the moment, which I thought was strange.

I would call back so as to get another person to help you. Sometimes it's the luck of the draw that you get someone incompetent and/or too lazy to help you. If you are still unable to get your questions answered, I suggest you call the personnel office that will be processing you when you start working. They should have a benefits specialist to help you.

Hopefully you won't get the run-around.

iuki


I don't know if this will be of help to you, but in the State of Florida, pain medication, e.g., oxycontin, percocet, etc., are written by pain management doctors at authorized pain clinics. The law now requires that the patient has to physically be seen by the doctor before getting a prescription for the medication. Therefore, a patient would be limited to a month's supply and would have to see the doctor every month to get a prescription for each month at a time. Your primary care physician cannot write the prescription for you. We don't have an HMO, but my husband has to go through this every month. The patient is also required to provide a urine specimen when you go in to see the doctor. So, this might be an example of "supply limit." - just a thought.

[yamahastar]

My husband and I worked for the State of Florida for 25 years and we always had Blue Cross Blue Shield and it was wonderful and we never had to worry about what you are talking about. One of the best people who can tell you things about medication coverage when your insurance company won't is a friendly pharmacist or pharmacy tech. I've also found my own HR people helpful. If a company won't answer your questions about their coverage, I think they've really just answered your question.