Health Care Reform-1/1/11 Flex change

[PatsMom]

We were told by DD's doctor to give her Zyrtec, and DH's doctor told him to take Niacin for his cholesterol, but nothing was written since they are OTC. I guess sometime this year (when we're at the doctor for something else) we'll need to get scripts for those.

What about contact solution? All 4 of us wear contacts. I usually spend about $100 when I go stock up on solution. Will I need a script from our opthamologst now?

As I understand it, yes you will need a script from your opthamologist to get reimbursed for your contact solution now. And you are correct that you will need the scripts for the Niacin and Zyrtec.

 

[wvjules]

Valid point--

However, it is also an added expense. I don't have any docs that will write a script over the phone without you being seen. So if I had a cold and need some mucinex to help--I'd have to call and make an appt, go in, spend my co-pay--then get a prescription to go buy something OTC.

The whole reason stuff is made OTC to begin with is to prevent unnecessary medical visits (or so I thought).

(Just using that as an example b/c that was my most recent need--icky mucinex...but it does the job well and in the end, no need to visit a doctor.)

Even my OB, whom I obviously see regularly--will only do limited scripts over the phone...and those are for things that aren't OTC anyway.

To me it seems to be more of a headache and creates more red tape than it takes away.

Perhaps there is more abuse than I am aware of, but I can't say that any time I had a FSA or HSA that I was inclined to buy some OTC meds under the table for anyone other than my covered family. Is it really that much of a problem?

Apparently there is an Advil drug cartel operating underground now.

 

[sbell111]

Perhaps there is more abuse than I am aware of, but I can't say that any time I had a FSA or HSA that I was inclined to buy some OTC meds under the table for anyone other than my covered family. Is it really that much of a problem?

I don't know if it's that big of a problem, or not. I also don't know that it's going to cause a bunch more work (and expense) for providers' offices or that a doctor would choose to see you related to a OTC script. Likely not, I suspect.

 

[PatsMom]

Apparently there is an Advil drug cartel operating underground now.

 

[sbell111]

Apparently there is an Advil drug cartel operating underground now.

Snark is a poor debate tactic when used on it's own.

 

[Lisa loves Pooh]

I don't know if it's that big of a problem, or not. I also don't know that it's going to cause a bunch more work (and expense) for providers' offices or that a doctor would choose to see you related to a OTC script. Likely not, I suspect.

PRobably b/c people won't bother b/c for many, it would require an office visit and that costs more than just schlepping up to Walgreen's to get what you need.

But it is naive to believe that Doctor's offices are going to freely offer OTC scripts without an office visit. It could be a malpractice problem.

 

[Piecey]

Valid point--

However, it is also an added expense. I don't have any docs that will write a script over the phone without you being seen. So if I had a cold and need some mucinex to help--I'd have to call and make an appt, go in, spend my co-pay--then get a prescription to go buy something OTC.

That would really annoy me- is that common in your area?? I could see it being a MAJOR issue in a situation like that!!

I've had to call the after-hours number for both my pediatrician and OB in the last month. Both times I got someone OTHER than our actual Dr.'s and both offered to call in a script for my son/myself without having ever met us.

My OB/GYN has called in a lot of prescriptions for me and the pediatrician calls in steroid creams for DS constantly (he's got major dermatitis)..

 

[wvjules]

Snark is a poor debate tactic when used on it's own.

Hmmm, I missed the part where I was debating anything.

 

[pansmermaidzlagoon]

I'm tired of getting points for responding to posts like this one, so I reported it, instead.

To the actual thread topic of needing a prescription in order for an expense to be covered under a flex account, this is necessary to ensure that the meds go to someone covered by the plan. As such, it's a smart change.

good point! I can see that being part of it.

I never considered abuse, I guess I don't personally see that big of an advantage in abusing it. Although one year we had a bit left over, DH went out and stocked up on too much stuff that we really didn't and wouldn't use beore exp date - I wish we HAD given some to family!

 

[Lisa loves Pooh]

Snark is a poor debate tactic when used on it's own.

It was perfect comic timing for a joke--I doubt WJules whole opinion can be centered around an Advil drug cartel.

 

[sbell111]

But it is naive to believe that Doctor's offices are going to freely offer OTC scripts without an office visit. It could be a malpractice problem.

Writing a prescription for an OTC med is no more of a malpractice issue than telling you to take the OTC med.

Our pediatrician's website has a fairly large area devoted to helping parents through the minor issues that they will face with thier young children. Some of the advice consists goes along the lines of 'give him some tylenol'.

 

[Lisa loves Pooh]

That would really annoy me- is that common in your area?? I could see it being a MAJOR issue in a situation like that!!

I've had to call the after-hours number for both my pediatrician and OB in the last month. Both times I got someone OTHER than our actual Dr.'s and both offered to call in a script for my son/myself without having ever met us.

My OB/GYN has called in a lot of prescriptions for me and the pediatrician calls in steroid creams for DS constantly (he's got major dermatitis)..

I have heard folks not having trouble getting a script called in.

But IME, for the doctors whom we have used--no, they will not do scripts over the phone (unless perhaps it is a refill or something. I have had to have a script changed for my DD from the psychiatrist once, but we had already been seen and we were trying to see if it would work and it didn't. But I still had to go and pick the prescription up as it was for a controlled substance).

But to state that there is no additional work or cost associated with this task so that folks can use their FSA/HSA dollars is a bit naive. Whether it is additional time for the doc (my OB doesn't do scripts of any kind over the weekends) or the need to make an appointment--there is a cost associated with this change. It is unfortunate.

 

[sbell111]

It was perfect comic timing for a joke--I doubt WJules whole opinion can be centered around an Advil drug cartel.

We all know where her opinion is centered. She just cannot discuss it here anymore.

 

[Lisa loves Pooh]

Writing a prescription for an OTC med is no more of a malpractice issue than telling you to take the OTC med.

The whole point of OTC meds is that you don't require permission to take them. Hence their availability of obtaining them OTC.

For a doctor to step in and say, over the phone..oh you just have a cold, sure I'll fax over a script for sudafed....

Only you've got more than a cold and you weren't seen and your condition worsens and develops into pneumonia....

Well now the doc who took your word without seeing you, *could* be held liable and subject to a malpractice claim.

If we are going to spout on about misuse of an HSA--we need to be honest about the burden this places on medical staff to provide their permission for you to take medications when they have not seen you to do an accurate diagnosis.

 

[sbell111]

I have heard folks not having trouble getting a script called in.

But IME, for the doctors whom we have used--no, they will not do scripts over the phone (unless perhaps it is a refill or something. I have had to have a script changed for my DD from the psychiatrist once, but we had already been seen and we were trying to see if it would work and it didn't. But I still had to go and pick the prescription up as it was for a controlled substance).

But to state that there is no additional work or cost associated with this task so that folks can use their FSA/HSA dollars is a bit naive. Whether it is additional time for the doc (my OB doesn't do scripts of any kind over the weekends) or the need to make an appointment--there is a cost associated with this change. It is unfortunate.

You are extrapolating their process for writing a script for controlled substances to include scripts for OTC meds. I suspect that they will utilize a much more streamlined method for OTC meds.

 

[Lisa loves Pooh]

We all know where her opinion is centered. She just cannot discuss it here anymore.

Sense of humor is not your friend, is it?

I don't care what her opininon is--she responded to something I said...to which you admit that there may not be such a big problem after all and you felt the need to return the so called snark.


I prescribe jokes and fun for the remainder of the afternoon.

 

[sbell111]

If we are going to spout on about misuse of an HSA--we need to be honest about the burden this places on medical staff to provide their permission for you to take medications when they have not seen you to do an accurate diagnosis.

I believe that you are greatly overstating the burden.

 

[Lisa loves Pooh]

You are extrapolating their process for writing a script for controlled substances to include scripts for OTC meds. I suspect that they will utilize a much more streamlined method for OTC meds.

Your ability to make a prediciton doesn't make it so though.

You are speaking with authority that you do not have to witness that it won't be trouble.

But it could be--you just don't want to admit it b/c in your thought process, this is a great thing so that fraud could be avoided. Yet you have no cited examples where fraud was even a concern to insprie this change in protocol.

And if you can cite how it takes no time at all to write a script, document that it was written and get it to the patient at no cost, I'm all ears. But I suspect that you can't do that. A more "streamlined" method doesn't make it cost-free or safe over the phone.

 

[Lisa loves Pooh]

I believe that you are greatly overstating the burden.

And I believe you are exaggerating the reasons for the change (fraud!) and overstating the simplicity as though it is a non-issue.

 

[PatsMom]

The fact of the matter is that I think most are not going to bother getting prescriptions for over the counter medications because they are not going to want to go through the hassle of getting a prescription from the doctor. So they will just go to CVS and pick up their over the counter medications and lose the tax break that they used to get. I believe the bill anticipates that this provision will be a revenue raiser which clearly means that the lawmakers anticipate that pre-tax spending on OTC medicines will decrease.

And for those, like me, who believe in paying no more tax than necessary, we will have to harass our doctors to get a written prescription for vitamins. Or Tylenol. Actually I won't, because I don't have a FSA available to me. But I know others who will.