Health Boards
It is very confusing! In the "old days" the doctor decided the treatment. So had Glenda needed two injections instead of one, if the doctor prescribed it the insurance was responsible for it. (Most policies then were pretty much an 80/20 with the insurance paying 80% and the patient paying 20% unless they had a supplemental insurance to cover that cost)
Unfortunately now, insurance companies get to decide if they feel you need it. If they will only pay for x amount of treatments then that's all you'll get. They make determinations based on averages and of course what can cost them the least amount of money. Insurance companies do not distinguish between individuals (as in one person may need less or more than another.) So Glenda is at the mercy of her insurance company to a certain degree. There ARE exceptions to this and sometimes doctors can push them into seeing the need.
Edited to add: Basically if the insurance company is faced with ok if you won't approve this then we can say this treatment didn't work and move to a more expensive treatment which can have the insurance company then seeing that it's to their benefit to approve the lesser cost.
Unfortunately now, insurance companies get to decide if they feel you need it. If they will only pay for x amount of treatments then that's all you'll get. They make determinations based on averages and of course what can cost them the least amount of money. Insurance companies do not distinguish between individuals (as in one person may need less or more than another.) So Glenda is at the mercy of her insurance company to a certain degree. There ARE exceptions to this and sometimes doctors can push them into seeing the need.
Edited to add: Basically if the insurance company is faced with ok if you won't approve this then we can say this treatment didn't work and move to a more expensive treatment which can have the insurance company then seeing that it's to their benefit to approve the lesser cost.