NHI responds to claims that it has stopped covering certain drugs
By Fitsroy Randall, BVI News Staff
Amid public complaints that the National Health Insurance (NHI) scheme has suddenly discontinued coverage of a number of medications, Executive Director of the NHI, Roy Barry, has sought to dispelled those claims, stating that his organisation has not ‘recently stopped’ covering any drugs.
He said the NHI — a state-owned body under the Social Security Board — has merely reiterated the list of over-the-counter (OTC) drugs that are not covered under the health insurance programme.
In an interview with BVI News on Monday, the NHI’s Executive Director said the health insurance programme only covers medication prescribed by a doctor and medical professionals.
He noted that NHI’s policy to not cover OTCs is not a recent thing. He said this rule has been in place since inception of the programme.
Providers wrongfully billing the NHI
However, Barry explained that pharmacies and other providers have been billing the NHI for OTCs. He said the NHI’s recent public release on the matter just served as a reiteration of the policy in question.
“We have recently been upgrading our systems and decided it was necessary to remind providers that the NHI does not cover over-the-counter drugs; only prescribed medication,” Barry stated.
When asked whether NHI was co-paying for the OTC drugs billed by the pharmacy, the Executive Director told our news centre ‘no’.
Barry warned that pharmacies must stop billing OTCs to the NHI as the NHI will not go against their own policy.
“What was happening was that the customers would go to the pharmacy and would co-pay for the medication but when the billing comes to NHI, we would review medication and issue payment for whatever we cover but not for OTC,” Barry said.
“The change customers are seeing now is the pharmacies/providers enforcing the rule that was there from the onset,” he added.
Drugs NHI does not cover
The NHI recently released a three-page list of OTCs that have been billed to them over the years. The list served as a reminder that these drugs are classified as OTCs and will not be covered under the health insurance scheme.
They are Piriton, Histal, Zyrtec, Claritin, Claritin-D, Allegra, Allegra-D, Periactin and Zedex. The list also contains the anti-infective medication, Vermox.
The NHI noted it does not cover blood formation and coagulation drugs such as Aspirin, Ferrous salt, and Ferrous salt + Folic acid.
OTC central nervous system medications such as Advil, Alleve, Panadol, Tylenol, Zomig Imigran are also not covered. The list also includes respiratory tract agents such as Bisolvon. Furthermore, eye, ear, nose, and throat preparations drugs such as Beconase, Difflam, Rhinocort, Canesten, Avamys, Flonase, Flixonase, Nasonex, Pataday, Nasacort are not covered by the health insurance scheme, while gastrointestinal drugs like Dulcolax, Colace, Nexium, Pepcid AC, Buscopan, Prevacid, Imodium, Losec, Prilosec are not eligible for co-pay.
The skin and mucous membrane meds Zovirax, Differin, Lamisil, Canesten, Econazole nitrate, Miconazole, Amorolfine hydrochloride, Hydrocortisone and Benzoyl Peroxide are also not covered.
Additionally, NHI announced it does not cover 88:00 vitamins such as folic acid, Pyridoxine, Thiamine, ascorbic acid, multivitamins, multivitamins + iron and the 92:00 miscellaneous therapeutic agent, Daflon.
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for dispelling the rumours
A rare event in the BVI
To me this is common sense. From the meds listed in this article, I don’t understand how/why the pharmacies would realistically be billing NHI for these OTCs and I also don’t understand why a customer would expect NHI to cover the cost of them. Highway robbery at its best! Smdh
I swear some people are just plain out RETARDED! NO Insurance covers over the counter drugs, NONE! They cover doctor visits and whatever medication is prescribed by the doctor, that’s it!
Thank you for clearing that problem up now for the big one when will you deal with people who take NHI deductions from their staff but don’t pay them in???
some doctors do prescribe drugs that can be purchased otc
There is nothing wrong from prescribing drugs you claim to be OTC if the patients are seen in the clinic.Some of the client come to the clinic with acute symptoms of the diseases of complications ,such as Peptic Disease.The appropriate thing for the Doctors to prescribe the drugs.
It will be nice for government to assist through NHI assist the patients because treatment may be prolonged and inadequate treatment could have deleterious complications.
The same may go for other diseases because of soaring cost of living in the community.
In addition some of the employers who deducted
NHI from employees without remitting them should be compelled to do so.This brings burden on the employees .
mr barry, while some of the meds listed re otc most of it at higher MG are prescription to save lives. nexium for example only 20mg available otc , 40mg is prescription which is a very important for people with stomach desease. so we cant put a otc stamp on everything . some otc meds in very high doses are prescription only and do save lives.
He clearly stated that they cover PRESCRIBED DRUGS so if the doctor prescribed the high dosage Nexium it should be covered.
I am shocked to see that the big time antibiotic Ceftriaxone (Rocephin) is not covered by NHI. This injectable medication cannot be purchased over the counter without a prescription so why is it not covered?
Point of correction. Zomig(Zolmitriptan) is a prescription drug not OTC.
I agree with the post that Nexium in high doses prescribed by health care providers should be subsidized by NHI. This will be life saving.
In addition some injectables prescribed in critical conditions which patient are still paying out of pocket should be looked into by government.
My doctor-prescribed medication was not on this list. But I still have to pay for it.
And get this, the government gets it FREE. It’s part of the free medication the OECS receives from the PAHO. Dr. *** told me this because the BVI ran out once, and so I tried to buy it online, but had a real problem finding it, and he explained why. By the time I had sourced this from Israel, the OECS donated the BVI another batch.
What the Government needs to do is cap the prices . Every pharmacy operating has wide disparity in prices
Charge less at customs on the pharmaceutical products and set price control
On the pharmacies for the ridiculously higher OTC drugs . Nobody wants to bell the cat and the masses are feeling the pressure
Everyone doing as he or she pleases
People do not follow rules a lawless place beginning from the top
They apply the rules to who is not in their circles
Cut out the middle man. The providers and the pharmacies look at NHI like pigs at a trough. Because they have no limiting factor they’re more then happy to bankrupt the system to fill their pockets.
It is nice to have reasonable prices .You must realize that the facilities or pharmacists purchase the medicines fro different companies at different prices. This means that you cant fix the price.
All these drugs even though OTC, some should have a cap. Not everybody can afford OTC for persistent health condition.
This is the smallest of all the NHI issues. The Biggest issue is the high cost of private care..Here is the2 solution..Co pay to private care 50-50⅞..Public care co pay 10%- NHI 90% get the service better at the out clinics..Let NHI money go back through the system..
NHI just another ponzi scheme
SO what if you went to a doctorand the doctor prescribe something and it so happen to be otc for instance 81mg aspirin. once a doctor prescribe it it should be covered by NHI if persons want to buy it without going to a doctor and getting a prescription then they should pay full price.
Barry obviously is not in control of his office or know what is happening there at NHI because many of us including me still can’t get reimbursed for doctor prescribed drugs. My neighbor in his 80’s is frustrated with the lack of help he gets from them when turning in his claims. The right hand don’t know what the left hand is doing there at NHI. That place need new blood from the head to feet, seriously. You go into the office to discuss your claims and all you get is promises promises and more promises a waste of time. I go in there and have to sit down for so long and hear same excuses after another and still nothing happens, everything is at a snail pace. Barry chose to only talk about Otc drugs to pacify the situation but neglect to talk about why honest residents filing a claim with doctor prescription can’t get reimbursed, he need to talk the true picture. A bunch of lazy lovers, that place definitely need to dismantle and start over again, starting with Barry and management. Barry, you need to roll your sleeves up and go into the departments and see the mess that’s really there, focus on everything rather than talking half truths.
So all the otc drugs listed that are not covered by NHI, what about if it is precribed by a doctor
NHI people are a huge disappointment. That place need a haul over