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PJ08

NO clue what I'm supposed to do

So, I've been battling moderate acne since 6th grade, I'm now 20 years old and on my last thread. I've tried absolutely everything under the sun for acne, but nothing has helped long term...at least 25 OTC products and 8-10 perscription/antibiotics.

I got really excited when I got a new derm who perscribed acutane without hesitation, 40mg twice daily. As soon as the pharmacy tried to claim it to insurance, however, it was almost impossible to resolve the prior authorization bs, and then I learned that acne was a pre-existing condition when my parents switched my insurance which basically means there is no way I'll ever be covered for ANY acne treatment.

That translates to a generic of Acutane costing me over $500 a month!! There's no way I can pay that. Does anyone know a way around this problem? Any antibiotics that I might not have tried work? Please someone help. Taking flax oil seems to be helping a little bit so I'm going to keep doing that and maybe try putting it on my face, but I'm not convinced that will clear me up completely.

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That's a toughie! Tell your doc, maybe he'll have some suggestions.

Sorry to hear about your bad luck :(

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I hate insurance companies. That is such bullshit they won't cover your acne treatments.

I have no idea what you can do, other than have a massive garage sale or use a credit card. $500/month is steep, though. $3000 for six months of treatment might be worth it to you if the acne is bothering you severely. It's about the same you'd pay for laser work and has more of a potential for permanent results.

If it were me, I'd probably do whatever I had to do to get on it, even if it meant going into debt for a little while. Fortunately, my hubby has really great insurance (Air Force), and I only had to pay $3/month for everything. However, my doc is also kind of a jerk, and I can't switch like I could in the civilian sector. SO, obviously his insurance has drawbacks as well.

I hope you can figure something out.

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Try to purchase your own insurance coverage. Read the fine print and they may let "acne" slide in because it wouldn't be considered a pre-existing condition. Anyway, some insurance may let you and even though you'd be paying a high amount in premimuns, it'll be worth it. Otherwise, save up and get it over the summer. Or phone some local agencies and see if they have any community programs which you may fall under. There is always "something" out there. good luck.

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You can try to fight your insurance company, but it will probably take a lot of work from your parents. They have to call constantly, look up envreything in the book and get a copy of the insurance agreement they signed. For example. my company has two forms.. the one they have us sign does NOT have that pre-existing condition cause because our HR lady knows that insurance will try to screw everyone over. Insurance co. doesn't provide a new form without the clause so she photocopies the old one over and over.

Have you mom or dad check to make sure that is not on the form they signed.

If that is a no go then have them call and fight - speaking to the supervisor.. then higher and higher until they get someone who can give you what you need.

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I really appreciate everyone's responisiveness. I'll ask some older people about their experiences with insurance companies and will find out if I can "slip" acne under the pre-existing condition radar. I'll also try getting in touch with people who posses more power within the company. This persistent acne has just been so emotionally draining.

I did talk to my derm, however, and this is what he is doing:

Since antibiotics are not acne specific I am covered using those (i hope), I was perscribed minocyclin and they're going to give me samples of tazorac and clindomyocin (sp?). I've already been through the taz and clin but that was a year ago so i guess you never know. I'm kind of scared of the mino from all these reports of this little bumps coming up, but i guess i should still try it. Any thoughts? Maybe there is hope but I'm not going to get too excited.

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The reason acne is a pre-existing condition for you is because you sought medical treatment prior to signing up for the new insurance company. Sorry to say, but its your fault for changing insurance (not your "fault" but you screwed yourself when you changed). Its smart business on the part of the insurance company; even though it does screw you and many others. I really doubt that your insurance company will cover any of your acne treatments; they aren't dumb, they know Mino is prescribed for acne treatment.

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The reason acne is a pre-existing condition for you is because you sought medical treatment prior to signing up for the new insurance company. Sorry to say, but its your fault for changing insurance (not your "fault" but you screwed yourself when you changed). Its smart business on the part of the insurance company; even though it does screw you and many others. I really doubt that your insurance company will cover any of your acne treatments; they aren't dumb, they know Mino is prescribed for acne treatment.

Well maybe if I had been a more compitent person 4 years ago in 2002, I would have been aware of my dad switching my insurance. I also played a varsity sport every season from my sophomore year in highschool on so I was pretty damn busy. Most of the time, 16 year olds aren't involved in deciding which health insurance to get, so if you want to blame anyone blame my dad for doing it. I know what a pre-existing condition is...that's not what I was asking, some insurance companies don't consider acne to be a serious enough condition to warrant its exclusion. I was wanting to know if anyone else had found away to circumvent this. Get you and your condescending tone the fuck out of here, because this is the last place I want to be criticized.

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Did you seek medical treatment for acne before your insurance was switched? If you weren't officially 'diagnosed' with acne by a doctoe until after the insurance was switched then I think it would not be considered a preexisting condition.

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The reason acne is a pre-existing condition for you is because you sought medical treatment prior to signing up for the new insurance company. Sorry to say, but its your fault for changing insurance (not your "fault" but you screwed yourself when you changed). Its smart business on the part of the insurance company; even though it does screw you and many others. I really doubt that your insurance company will cover any of your acne treatments; they aren't dumb, they know Mino is prescribed for acne treatment.

Well maybe if I had been a more compitent person 4 years ago in 2002, I would have been aware of my dad switching my insurance. I also played a varsity sport every season from my sophomore year in highschool on so I was pretty damn busy. Most of the time, 16 year olds aren't involved in deciding which health insurance to get, so if you want to blame anyone blame my dad for doing it. I know what a pre-existing condition is...that's not what I was asking, some insurance companies don't consider acne to be a serious enough condition to warrant its exclusion. I was wanting to know if anyone else had found away to circumvent this. Get you and your condescending tone the fuck out of here, because this is the last place I want to be criticized.

I don't think Spezza was trying to be an ass. I think it was more like a "sorry but you're screwed" kinda thing. It's sometimes hard to tell what tone people are speaking in when it's all typed.

I don't know how all this stuff works with ins. and what not, but I would definately start saving up some cash. Maybe sell some of your stuff, if your parents see how important this is to you, they might be sympathetic and help. No?

I really feel for you. I would go insane if I had the script, but no money to fill it.

Hope things work out for you.

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Spezza, sorry, I had a realy stressful day that day and was studying until 3AM.

I found out that there is a law limiting the period which insurance companies can exclude coverage on a PE. The maximum amount of time is at the most a year or maybe two. My insurance was switched 4 years ago, so I'm going to check up on that tomorow. Thanks for the replies.

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Spezza, sorry, I had a realy stressful day that day and was studying until 3AM.

I found out that there is a law limiting the period which insurance companies can exclude coverage on a PE. The maximum amount of time is at the most a year or maybe two. My insurance was switched 4 years ago, so I'm going to check up on that tomorow. Thanks for the replies.

That's good news. I hope this works out for you!

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Shop around-you should be able to get it for cheaper...I had the name brand and it was $230/month, no insurance. It was in Canada, but still, $500 is really steep.

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Spezza, sorry, I had a realy stressful day that day and was studying until 3AM.

I found out that there is a law limiting the period which insurance companies can exclude coverage on a PE. The maximum amount of time is at the most a year or maybe two. My insurance was switched 4 years ago, so I'm going to check up on that tomorow. Thanks for the replies.

Yeah I was thinking the same thing as I was reading through this. I remember when I was shopping around for health insurance, I noticed that I would have to wait at least a year before they would cover my preexisting condition(acne). If it's been 4 years since your dad switched insurance.. you should be fine. I think your insurance company just doesn't want to pay! :naughty:

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Spezza, sorry, I had a realy stressful day that day and was studying until 3AM.

I found out that there is a law limiting the period which insurance companies can exclude coverage on a PE. The maximum amount of time is at the most a year or maybe two. My insurance was switched 4 years ago, so I'm going to check up on that tomorow. Thanks for the replies.

Sorry, I may have come off as rude. I didn't mean to, just pointing out the reality of the situation.

The year rule may not apply. My best friend works in insurance - claims department - and I asked off-handedly about "pre-existing conditions" clauses. Basically what she said was in many policies they will totally exclude chronic pre-existing conditions, which acne would fall under. Hope that isn't the case with your policy.

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