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Insurance Companies change their formularies almost every year to define which medications they will or will not cover. Some will only cover generics on certain items, others define certain brands they WILL pay for and ones they will not. If a Physician insists on a particular medication that is not on the formulary, he can request an override. If the Insurance Company refuses the Override, the doctor can choose an alternate medication that IS covered, or the patient can opt to pay out of pocket for the non-covered medication.

You're correct, but those niceties could be a thing of the past with Obamacare-compliant policies becoming mandatory for many employers and many individuals and families being dropped from coverage by their employers. With those new policies, I believe the drugs and devices covered will mandated by Big Brother, and I don't think there will be as much flexibility as we've become accustomed to. (Of course, they will also cost a lot more.)

Let's not lose sight of the number one goal here: Repeal Obamacare ASAP!!!