Surprised: Blue Shield Covered Finasteride 5mg... Perhaps B/c Of Way Prescription Written?

[patrick456]

Hello!

So I've been using finasteride for years to prevent hair loss and years ago my insurance (Blue Cross at the time) covered it and it was shocking to the pharmacy as they never saw it as being covered.

So over the last few years, no insurance offered coverage. So I had my doctor fax it to a reputable Canadian pharmacy. But of course, with good prescription drug benefits, the co-pay would always be preferable.

So, my doctor sent in finasteride 5mg to my regular pharmacy as a mistake as I was preparing to have it be faxed to a Canadian pharmacy and it turned out that my insurance covered it. I don't know why as I looked up the formulary, and it isn't on there except for BPH... only 5mg and the generic and not 1mg.

So, I'm surprised they covered it these years later! I looked at the label and it says to take one 5mg pill per day. So I'm wondering if the insurance company just assumed it was for BPH?

Anybody ever figure it out? Insurance is not clear cut and so it seems to me that everybody with good prescription insurance should just try submitting it to insurance to see what they say.

It would be great if the insurance would cover the 1mg variation. But I have doubts.

Patrick

 

[AnxiousAndy]

Hello!

So I've been using finasteride for years to prevent hair loss and years ago my insurance (Blue Cross at the time) covered it and it was shocking to the pharmacy as they never saw it as being covered.

So over the last few years, no insurance offered coverage. So I had my doctor fax it to a reputable Canadian pharmacy. But of course, with good prescription drug benefits, the co-pay would always be preferable.

So, my doctor sent in finasteride 5mg to my regular pharmacy as a mistake as I was preparing to have it be faxed to a Canadian pharmacy and it turned out that my insurance covered it. I don't know why as I looked up the formulary, and it isn't on there except for BPH... only 5mg and the generic and not 1mg.

So, I'm surprised they covered it these years later! I looked at the label and it says to take one 5mg pill per day. So I'm wondering if the insurance company just assumed it was for BPH?

Anybody ever figure it out? Insurance is not clear cut and so it seems to me that everybody with good prescription insurance should just try submitting it to insurance to see what they say.

It would be great if the insurance would cover the 1mg variation. But I have doubts.

Patrick

They are likely covering it because they think it is for BPH, I personally think the 5mg pills are better, you get slightly more in a dose if quartered and it is a lot cheaper (for your insurance)