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Insurance Carrier: Medica HMO Choice
State: Minnesota

Consumer Complaint:

I'm insured with Medica choice -- my own personal policy. I've had this insurance since the 1980's. Lately they have gone to generic drug manufactures which I do not have a problem with except when they do not perform as good as the prescribed drug from my doctor. In June of 2008 Medica switched me over to a generic strain from Lipitor, I tried it and it gave me leg cramps and my current lipid test my LDL was much higher and my HDL lower. All I want is my Lipitor I pay my premiums on time and I did not agree they go against my doctors input.

Insurance Expert Answer:

The story is simple. Zocor and Lipitor do pretty much the same thing and were both patented and expensive. (Think "obscene profits.") BUT when Zocor went off patent a year or so ago, the original manufacturer and generic manufacturers dropped the price significantly.

ALL drug companies took Lipitor off "formulary." In MANY plans, where there is what is regarded as a generic equivalent available you can only get the patented drug IF you go through a series of steps, trying the less expensive generic, having your doctor rule them out one by one, writing to the drug plan, and then go back to the tried and true.

Your plan probably has a procedure for doing that, and yes its a hassle, but the overall savings are major given that for most people generics do as well as the patented drug. There is some good news - Lipitor itself goes off patent in a year or so.