Hi, new to this sub, will appreciate any advice…I have a chronic disease and have been receiving a medication for the past 4 years that has out me in remission. I got sick in November and had some symptoms from my chronic disease. My doctor prescribed some medication, I got better and am back in remission (I have multiple lab results to support remission). Insurance is now denying my medication on the basis of “it’s not working anymore.” My doctor is great and has appealed the decision and provided the lab results, but insurance is still denying the medicine. We (my doctor) now need to prepare a secondary appeal. What can we do/say to get this appeal through? Is there any specific verbiage, any specific person that I can invoke? If I don’t continue the medication, I will likely get very sick. TIA for your help.
submitted by /u/Roadsidedagny
[link] [comments]Hi, new to this sub, will appreciate any advice…I have a chronic disease and have been receiving a medication for the past 4 years that has out me in remission. I got sick in November and had some symptoms from my chronic disease. My doctor prescribed some medication, I got better and am back in remission (I have multiple lab results to support remission). Insurance is now denying my medication on the basis of “it’s not working anymore.” My doctor is great and has appealed the decision and provided the lab results, but insurance is still denying the medicine. We (my doctor) now need to prepare a secondary appeal. What can we do/say to get this appeal through? Is there any specific verbiage, any specific person that I can invoke? If I don’t continue the medication, I will likely get very sick. TIA for your help. submitted by /u/Roadsidedagny [link] [comments]Read Morer/HealthInsurance