I’m probably going to give too much info but I want to make sure my bases are covered.
I am 25, living in California, and get health insurance under my parents’ United Healthcare HMO plan. In 2020 I was prescribed Emgality by my neurologist, and I was being billed under my medical insurance instead of my pharmaceutical insurance, so I was paying $0. Towards the end of 2020 I received a letter saying UHC would not cover my healthcare system in 2021 and they were switching me to another one. After switching, my prescription was going through OptumRx and it was $40 a pop. I tried multiple times to get it billed the way it was at the last healthcare system, to no avail.
In May I received a letter saying my prior authorization was expiring at the end of June because they couldn’t get in touch with my doctor (because she was no longer my doctor, because they switched my provider 🙄). I made an appointment with the neurology department in my current healthcare system but it’s not until August 16, and I need another dose by August 9.
I logged into the UHC website the other day and there was an option to order medication, which I don’t think was there previously as I always had to go through the OptumRX website. I placed an order and the total was $0 but subject to change- I crossed my fingers. Huge mistake. I’m going to be charged $1800.
tl;dr- if I ordered medication after my prior auth expired and the cost is too high, should I just cancel the order? Or will a new prior auth cover what I already ordered?
submitted by /u/sadadviceaccount
[link] [comments]
I’m probably going to give too much info but I want to make sure my bases are covered. I am 25, living in California, and get health insurance under my parents’ United Healthcare HMO plan. In 2020 I was prescribed Emgality by my neurologist, and I was being billed under my medical insurance instead of my pharmaceutical insurance, so I was paying $0. Towards the end of 2020 I received a letter saying UHC would not cover my healthcare system in 2021 and they were switching me to another one. After switching, my prescription was going through OptumRx and it was $40 a pop. I tried multiple times to get it billed the way it was at the last healthcare system, to no avail. In May I received a letter saying my prior authorization was expiring at the end of June because they couldn’t get in touch with my doctor (because she was no longer my doctor, because they switched my provider 🙄). I made an appointment with the neurology department in my current healthcare system but it’s not until August 16, and I need another dose by August 9. I logged into the UHC website the other day and there was an option to order medication, which I don’t think was there previously as I always had to go through the OptumRX website. I placed an order and the total was $0 but subject to change- I crossed my fingers. Huge mistake. I’m going to be charged $1800. tl;dr- if I ordered medication after my prior auth expired and the cost is too high, should I just cancel the order? Or will a new prior auth cover what I already ordered?
submitted by /u/sadadviceaccount [link] [comments]Read Morer/HealthInsurance