Are My Prescriptions Covered Under Worker’s Compensation?

Doctor and patient

Many questions that we get about workers’ compensation insurance revolves around prescriptions. These questions include:

Are my prescriptions covered under my workers’ compensation insurance?

  • Yes, to the relief of many, you will be entitled to your prescriptions under your employer’s workers’ compensation insurance.

Why does my insurance company tell me I can only get my prescriptions at specific pharmacies?

  • In 2007, worker’s compensation law changed. Under this change, insurers can designate specific pharmacies where injured workers can obtain their medications. The carrier is required to notify you of the requirement, as well as notify you in writing which local pharmacies you are allowed to use. They are required to include the name and addresses of these local pharmacies.

Can my insurance carrier prevent me from receiving the medications I am currently on?

  • No, the carrier has no authority to tell you which medications you should take. This decision is one between you and your doctor, and the carrier must respect the prescriptions that your doctor has provided for you, as long as the medications are consistent with the Non Acute Pain Medical Treatment Guidelines.

What do I do if my carrier refuses to pay for a medication that I was prescribed?