CVS Caremark No Longer Covering 2 of My Family’s Needed Prescriptions. Help Is Appreciated!

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I just received two letters from CVS Caremark as they are the pharmacy benefit manager for my spouse’s health plan. I’m looking for a little advice at how to handle these issues.

  1. My son suffers from eczema and uses Derma-Smooth Body Oil 0.01%. He previously used the generic version, but there was a large price hike, and the BRAND was cheaper than the generic. The letter that we received says that the Derma-Smooth will no longer be covered, and instead, he can use a generic topical corticosteroids. This seems ridiculous to me as the cost of the bottle of generic Fluocinolone Acetonide 0.01% is $123.86. Conversely, the Derma-Smooth was $36.20. Is there a way that I can appeal this?
  2. My husband had thyroid cancer and had a thyroidectomy. Afterward, his endocrinologist mandated that he take Synthroid vs. generic, and I have seen research suggesting that those who have had thyroid cancer should not take generic levothyroxine due to fluctuating TSH. The Synthroid will also no longer be covered.

    I am hoping that you also know what steps that person could possibly take to get the prescriptions covered.

As far as the body oil goes, I know that I could use GoodRX or just pay out of pocket, but then I don’t think it would count toward our deductible. Our insurance includes medications as counting toward the deductible.

Thanks in advance for any help you can provide!

submitted by /u/Vindwyn
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I just received two letters from CVS Caremark as they are the pharmacy benefit manager for my spouse’s health plan. I’m looking for a little advice at how to handle these issues.
My son suffers from eczema and uses Derma-Smooth Body Oil 0.01%. He previously used the generic version, but there was a large price hike, and the BRAND was cheaper than the generic. The letter that we received says that the Derma-Smooth will no longer be covered, and instead, he can use a generic topical corticosteroids. This seems ridiculous to me as the cost of the bottle of generic Fluocinolone Acetonide 0.01% is $123.86. Conversely, the Derma-Smooth was $36.20. Is there a way that I can appeal this?
My husband had thyroid cancer and had a thyroidectomy. Afterward, his endocrinologist mandated that he take Synthroid vs. generic, and I have seen research suggesting that those who have had thyroid cancer should not take generic levothyroxine due to fluctuating TSH. The Synthroid will also no longer be covered. I am hoping that you also know what steps that person could possibly take to get the prescriptions covered.

As far as the body oil goes, I know that I could use GoodRX or just pay out of pocket, but then I don’t think it would count toward our deductible. Our insurance includes medications as counting toward the deductible. Thanks in advance for any help you can provide!
submitted by /u/Vindwyn [link] [comments]Read Morer/HealthInsurance

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