insurance fraud Proscar?

[jazzsnazz]

i've been on Propecia for 3 months which equates to $250, and recently a doctor switched it to Proscar upon my request because of the financial benefit, i just got a year supply for $9 because it is covered by insurance, since i'm taking it because of hair loss and not prostate problems, is that fraud, could i get in trouble, could the doctor?

[Rhino3]

I'm no lawyer, but I don't think so. I think this is common, and both my regular doctor and my HT doc have done this for me. It's not as if you or the doctor determine what is or isn't covered under your plan, or tell the insurance company all the details behind why the doctor provided it to you -- it's the insurance companies job to justify coverage, and you haven't provided them with any misinformation. My old insurer covered it, but my new insurance doesn't cover proscar for anyone under the age of 30. I think the insurance companies are catching on...

[jazzsnazz]

thank you for the response, but I am still skeptical, i have been to a hair doctor endorsed by this network who would not perscribe Proscar but only Propecia, you should read these articles.

 

http://www.medscape.com/viewarticle/456510

 

 

New Baldness Drug Is Older Product at a Premium Price - NYTimes.com

[jazzsnazz]

 

http://www.medscape.com/viewarticle/456510 <---will not work, in google type in "insurance fraud proscar" 6th down, a lawyer actually talks about the issue...the heading is "Insurance Fraud to Save a Patient Money on Prescriptions?"

[Spanker]

Yes it can be a bad idea to buy it through your insurance. I pay for it outright at wal-mart and it is still only 15 bucks a month.

[Dr. William Lindsey]

I have thought about that a number of times. I personally won't prescribe proscar for a couple of reasons. BUT, I tell all guys my age (now 46) or older, that they can certainly check with their primary doctor and see if they should consider proscar, in which case propecia is not necessary, and they can just get proscar....and likely protect their prostate.

 

Also, medicolegally, my carrier frowns upon me treating prostate problems...

 

I can certainly sympathize with the monthly cost of propecia but worry about the ramifications of prescribing proscar for hair. I may be the doctor referred to above who would not prescribe proscar to the patient.

 

Dr. Lindsey McLean VA

[Al - Moderator]

Drs are allowed to prescribe things for uses other than they are intended as long as they feel it would be beneficial to the patient. Obviously proscar would be as beneficial as propecia because it's the exact same thing, so I can't understand why a Dr would not prescribe it as long as they don't submit it to the insurance company. What the patient does after he leaves the office (whether the patient submits a claim on their own or not) is up to the patient and the Dr can't be held responsible for any insurance fraud.

 

If your insurance covers proscar for prostate problems, but not hairloss, then simply don't use your insurance for it. You can pay the entire cost with no need to feel guilty about insurance fraud since you haven't used your insurance.

[Spanker]

Drs are allowed to prescribe things for uses other than they are intended as long as they feel it would be beneficial to the patient. Obviously proscar would be as beneficial as propecia because it's the exact same thing, so I can't understand why a Dr would not prescribe it as long as they don't submit it to the insurance company. What the patient does after he leaves the office (whether the patient submits a claim on their own or not) is up to the patient and the Dr can't be held responsible for any insurance fraud.

 

If your insurance covers proscar for prostate problems, but not hairloss, then simply don't use your insurance for it. You can pay the entire cost with no need to feel guilty about insurance fraud since you haven't used your insurance.

 

 

+1

 

Exactly

[RCWest]

Merck executives, meanwhile, are frowning heavily over splitting pills. ''We don't recommend that people try to divide Proscar tablets to create a dose of Propecia,'' said Raymond V. Gilmartin, Merck's chairman and chief executive.

 

''For one thing, there's the precision involved; Propecia is one milligram of finasteride,'' Mr. Gilmartin said of the active ingredient. ''It's hard to split a pill and come away with exactly that amount.''

 

WTF?? Only because it's in their interest to profit! So what if you take a little extra. Most people 1/4 a tablet because it's easier. Generic medications have a +15/-20% allowance in active ingredient. Cutting a 5 mg. generic Proscar into 1/4 may actually end up being closer to 1 mg. if it's a weak batch.

 

BTW, my insurance won't pay for Proscar, but it will pay for Avodart! I think they have caught on to people already. I guess you have to be over a certain age before they will allow it. If they release a form of Avodart for hairloss in the future, then they will probably do the same thing.

Edited October 5, 2010 by RCWest

[Blake Bloxham]

Jazzsnazz,

 

Have you discussed your concerns with the prescribing physician? It may be worth it to discussion your fears with him/her next time you're in the office. My guess is that the doctor could provide a very concise explanation and relieve any stress related to the situation!

[jazzsnazz]

an off topic question Dr. Lindsey, but i saw on the internet someone got an otoplasty procedure from you, what's your approximate cost? i'm saving up right now, and look foward to a consultation in the following weeks.

[Johnny1386]

Well Homer Simpson did something Similar, " keep brain from freezing" when he ordered his hair growth prescription and put the prescription under the insurance of the company ....got promoted in the company because of his new thick hair growth ...but evenetually was found out by smithers and lost the hair and his promotion

[Dr. William Lindsey]

Jazzsnazz,

 

I suspect you saw the fellow that I did an FUE on a few years ago who posted on this forum who came back last summer, or the year before...I can't recall, and got an otoplasty. He is a bigger blogger and lives in Europe. I know he posted my FUE on a few sites, then his otoplasty, and while he was here, we did his wife's eyelids in the office and he posted that too. He's quite a character and at one time was planning on starting his own forum somewhere over in Scandanavia I think.

 

Anyhow, I focus on hair 3 days a week, but do face procedures 2 days a week. Feel free to email me if you have specific questions. I think my face site is linked to the hair website and vica versa. www.novafaces.com and prices are for all to see, just as with our hair prices.

 

Thanks

Dr. Lindsey McLean VA

[Jotronic]

To the OP. If you are concerned about being busted for insurance fraud you could just as well continue on Proscar but pay for it out of pocket. The cost of generic Proscar would be roughly 60 bucks a year, or even better, 5 bucks a month. Problem solved.