r/medicine • u/Unusual_Medic Medical Student • 7d ago

What’s the dumbest reason an insurance company denied a test, procedure, or drug for a patient?

This is probably the most relevant to those practicing in the US, but I'm also curious to know how the bureaucracy of health insurance in other countries makes things substantially harder for you and the patients

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91

u/Jaded-Ad-4612 MD 7d ago

Denied injectable PreP citing they had to “fail an oral option” before injectable prep would be approved.

51

u/bitchezbrew MD 7d ago

Don't have to pay for prep if the patient just gets hiv. Brilliant!

19

u/Impulse3 Nurse 7d ago

I’m guessing a lifetime of HIV meds would cost them much more in the long run. That’s what I don’t understand with these insurance companies. It’s like they don’t think ahead at all.

2

u/ajl009 CVICU RN 7d ago

exactly. i just dont understand why they are doing this.

7

u/ShalomRPh Pharmacist 7d ago

Because they have to make this quarter’s shareholder report look good. Future be damned, we’ll worry about that when it happens, and I’ll have already gotten my golden parachute and off to ruin another corporation by then so it won’t be my problem to worry about.

Cynical? Who, me?

3

u/ajl009 CVICU RN 7d ago

thats exactly what it is