Medication coverage and pharmacy issues
looking for anyone whos been through this because im at my wits end. i have crohns and ive been stable on stelara for almost 3 years. infusion every 8 weeks, life is good, no flares. open enrollment...
Posting this because specialty drug prior authorization denials on biologics (Humira, Remicade, Stelara, Entyvio, Skyrizi) and small-molecule agents (Xeljanz, Rinvoq, Zeposia) for inflammatory bowel...
I take a brand name biologic injection for psoriatic arthritis that has been on my plan's formulary since i started it in 2022. Got a letter last week saying as of July 1 its being moved to...
I am at the point where i need to scream into a pillow before every phone call to CVS Caremark. My son is 14, diagnosed with juvenile idiopathic arthritis 18 months ago after about a year of...
I'm losing my mind a little bit so apologies if this is rambling. My 6 year old has been on a specialty seizure medication (it's one of the newer ones, brand name only, no generic) for about 14...
I have been on the same ADHD medication for 4 years. It works, my psychiatrist manages it, my life is functional. Then my employer switched insurance plans in January and suddenly my medication...
Doctor prescribed a medication my insurance classified as Tier 4 ($800/month copay). Doctor filed a tier exception request explaining why the lower tier alternatives dont work for me (Ive tried three...
My doctor prescribed a medication that costs $800/month AFTER insurance. Insurance says its a tier 4 specialty drug. The generic isnt available yet. Are there any options here? Manufacturer coupons?...
Been taking the same medication for 3 years with no issues. Went to refill it last week and got denied. Turns out my insurance changed their formulary at renewal and my medication is no longer...
Doctor prescribed a medication thats been working great for me but insurance wants prior auth every time. Theyve denied it twice even with my doctor sending supporting documentation. Is there an...
Finally settled my prescription claims claim and I have to give credit to the public adjuster I hired. Initial offer was $4,200. Final settlement was $18,500.Yeah they take a percentage but I still...
Got the offer letter for my prescription claims claim today. They want to give me $1,800. The repair estimate is over $12,000.Are they serious? How do they expect anyone to accept this? I'm so...