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If you have nasal polyps, you know that this treatment is important for your quality of life.
Make health insurance treatment
The insurance of health insurance is different, so you should always check the specific features of your guidelines. In view of the criteria or illnesses, for example:
- Medical need: Show that nasal polyps affect their health.
- Steps therapy: First try the cheaper treatment and show that it doesn’t work.
- For example, you could have to try steroids before you can receive a biopharmacus or the approval of the operation.
- Previous approval: Get the approval of certain treatments, services or medical recipes so that the insurance covers you.
- Approval is usually carried out depending on medical needs, security and costs. Your Medical Care Provider (HCP) will submit the application for prior approval.
- Other conditions: You can only receive an approval for a biopharmacus if you meet certain conditions, e.g. B. that you also take a steroid.
Potential inconvenience
Your health plan cannot cover the treatment of nasal polyps for the following reasons:
- The people responsible do not believe that treatment is necessary from a medical point of view: they could have to prove that they had had difficulties with symptoms for at least 12 weeks.
- You have not tried any other medication and have not improved: It is possible that those responsible make certain methods first (e.g. steroids) before other methods such as operations or other drugs (e.g.
- The people responsible believe that the treatment is cosmetic: make sure that the cover application focuses on how polyps influence their breathing or other medical problems.
- Your surgeon or the medical center does not belong to the network: You may have to lead consultations with a medical provider who is a member of the network of your health plan so that the operation covers.
No ters
- Medical insurers often deny the admission of the first inquiries. If you need treatment for a medical reason, do not give up. You can be successful if you work with your medical provider to provide a calling with further evidence of why you need it.
- What you should look for in your medical plan
- Copagaches and Co -Guros: Check the cost division of your plan. You can pay a fixed commission (additional payment) or a percentage of the total costs (CO -Lash) of the treatment. If you have a deductible, you may have to cover it before the insurance starts with the output of payments.
- Covered medication: You can see which medication is treated in your plan by checking the “form” or the list of preferred medication. It shows the payments without reimbursement that you have to do for medication.
- Previous authorization and other rules: Make sure that you understand which medication or services require the approval of your health plan. Let your provider help you to apply for approval.
- Supplier network: Check the list of providers that participate in your region.
This educational resource was created with the support of Sanofi and Regeneron.
