Thread Drift

[betagirl]

Not to change the subject because I'm really enjoying this hairball discussion

But my marvelous health insurance, Aetna, just denied me coverage of a medication I've been on for oh, 2 years. They covered it last month. I guess they want to take August off? The stuff is uber expensive so I can't just go buy it.

WTF? I cannot know WTF unfortunately until they get their arses into the office tomorrow at 6am Pacific time.

I can't wait to hear the reason.....and their timing is impeccable as always.

[SadieKate]

Betagirl, have you looked on their website to see if they publish a formulary or some kind of approved list?

[maillotpois]

Do they perhaps want you to get it from a different source? When I had to have the lovenox shots, my HMO covered one series and then put its foot down and said I had to go to some mail order place to get it instead of my Safeway pharmacy. The shots ran over $1000 per week (which actually isn't much compared to some of my friends' cancer drugs, but more than I feel okay about paying per week - though if you're looking at "Hmmm $1000 or my health?" you start doing a lot of growling.). Anyway, maybe there's a different way of getting the stuff?

[betagirl]

It's in their formulary, though I'm using it for off label use. It's still in trials for crohn's.

I'm guessing they may want me to go mail order. I'm hoping that's it. But Walgreens said something about a letter/forms that my doc needs to fill out. I went through all this crap 2 years ago to get coverage. It was such a fight then. I'm under a new policy now, so some bean counter must have figured this out and can't cross reference my old company policy. God forbid the computer system is that sophisticated I have their PPO. I'm just frustrated because I've had so many fights with insurance over the past 4 years. I thought it was all hashed out. Apparently not.