Horizon Healthcares prescription description

January 26, 2010

Institute For Medical Wellness Healthy Living Report


Horizon Healthcares prescription description

Actually I could call this Horizon Healthcares prescription deception.

If you ever had questions as to why I refuse to contract with insurance companies, please read this letter from Horizon Blue Cross Blue Shield of New Jersey. In Horizon's ever growing need for power and control of your health, they have put new requirements on prescription drugs. Requirements is probably a nice word. The correct words could be barrier, intruder, or pain-in-our-assets.

In Horizon's infinite wisdom, they will no longer approve any brand name drug, unless you have failed one or more of their preferred generics. Yes you heard it correctly! They will no longer approve for payment any Brand Name Medications unless and until you have failed generic medications.

Here is my question to you:

WHY DO YOU EVEN HAVE A PRESCRIPTION PLAN IF IT WILL NOT PAY FOR THE HIGHER PRICED MEDICATIONS?

Sorry for shouting, but the lunacy of this issue is amazing.

Go to Walmart, Costco, Sams Club, Wegmans, or many of the local independent pharmacies. You can obtain generic medications very cheaply without a prescription plan.

Yet Horizon considers their program as "prescription benefits." Just who is it benefitting???

Next question:

WHY CAN'T WE BUY HEALTH INSURANCE THAT DOES NOT INCLUDE A PRESCRIPTION PLAN IF THEY WILL NOT PAY FOR ANYTHING EXPENSIVE?

Sorry again for shouting. It is probably just my ADD acting up. My mother used to say that I had ADD. But I didn't believe her. Hey Look. A Chicken!!!

Sorry bout that ; )

I'll answer that question now for you.

Prescription plans are big money makers for your insurance company as well as for the pharmacy benefit managers that run them. I'll discuss more about these bureaucratic middlemen, their exhorbitant profits, and their backroom deals to keep their earnings high, and your costs even higher at a later date.

We should call our Congressmen and have them look into this for us. But we know where that will probably get us. Big insurance and pharmacy benefit managers contributions to their political campaigns, which in the end would leave us worse off, as is most healthcare related items when the government gets involved.

My suggestion to you. If you get turned down for a prescription by your insurance plan, call them. Spend as much time as you can. Sit in a nice relaxing chair at home or work. Tell them you have all day to discuss the matter. Continually ask to speak to their supervisor, over and over and again, until maybe, just maybe they will approve your medication. If not, get everyone's name and job description along the way. Let them know that you will hold them personally and their business fully responsible for any adverse medical outcome related to their decision to withhold medication that was prescribed by your physician. They are not doctors. Yet they are changing what your doctor has prescribed. These tactics do not always work, but if enough people start a ruckus, momentum will shift and the proper change can be instituted.

As an aside, there are actually more middlemen starting businesses due to this insurance precert mess. Visit www.mdinsuranceauth.com . They sent me a fax last week. Their business was set up to help doctors "eliminate your time consuming and costly process of obtaining authorizations for your patients."

Only in America. A new business focused on the insurance-government third party debacle!!

I am sorry. Healthcare does not need to be this complicated.

Here is my idea of the ideal healthcare system.

Doctor --------> Patient

You know what? The above ideal healthcare system looks alot like The Institute For Medical Wellness.

Look Again. No middlemen!!

Healthcare costs less when patient's have the freedom of choice, without all the middlemen in the way of better health!

Hey! I can dream, Can't I ??
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Interesting Article:

Low-Carb Diet Effective at Lowering Blood Pressure

This study compared a low-carb diet to the over the counter drug Orlistat- combined with a low fat diet. Over twice as many individuals on the low-carb diet 47%, versus the Orlistat-low fat diet 21%, were able to decrease or come off of their blood pressure medications. So the old saying that, "once on a blood pressure medication, always on a blood pressure medication", has once again been proven false. If you need help with a lower carbohydrate diet, please look into our Healthy Weight Program.


Healthcare Reform Update:

My views on healthcare reform are pretty well known by now. With the election of Scott Brown in Massachusetts, many pundits felt that the present reforms were dead. Unfortunately it may not be! There are many rumors circulating of more back room political deals to find a way to shove these reforms down our throats. I encourage you to remain involved in the debate, and do not let your guard down.


To Good Health!


Steven Horvitz, D.O,
Board Certified Family Practice
Founder of The Institute For Medical Wellness
128 Borton Landing Road, Suite Two
Moorestown, NJ 08057
Phone 856-231-0590
Fax 856-294-0311
www.drhorvitz.com

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