UHC decided to stop covering an expensive medication that my wife needs to take. It’s a anti-psychotic that was the first medication that actually helped her feel and be stable.
It is $1300/months without insurance.
So far her psychiatrist tried twice to get prior authorization but it has been denied twice. I’m not quite sure where to go from here. The manufacturer has options to help, but only if you make below 400% poverty level – we do earn more money than that.
My wife is on my employers plan, but it is paid pre-tax which I read means I can’t cancel her insurance and get private one.
I do plan on appealing it at UHC but I’m not yet sure how to go about this. I’m trying to collect information about this. Psychiatrist says she recently had someone else on UHC where they just plainly denied it so I’m not sure if this will happen.
UHC also has the medication listed as non-formulary. They did cover it without problem for at least the last 2 years.
Is there anything else I could attempt to get this covered? While we do make a reasonable amount of money, $1300/month is still very much impossible to make happen.
Edit: zip code 43062, age ~30, income too high for any help.
submitted by /u/patzor
[link] [comments]
UHC decided to stop covering an expensive medication that my wife needs to take. It’s a anti-psychotic that was the first medication that actually helped her feel and be stable. It is $1300/months without insurance. So far her psychiatrist tried twice to get prior authorization but it has been denied twice. I’m not quite sure where to go from here. The manufacturer has options to help, but only if you make below 400% poverty level – we do earn more money than that. My wife is on my employers plan, but it is paid pre-tax which I read means I can’t cancel her insurance and get private one. I do plan on appealing it at UHC but I’m not yet sure how to go about this. I’m trying to collect information about this. Psychiatrist says she recently had someone else on UHC where they just plainly denied it so I’m not sure if this will happen. UHC also has the medication listed as non-formulary. They did cover it without problem for at least the last 2 years. Is there anything else I could attempt to get this covered? While we do make a reasonable amount of money, $1300/month is still very much impossible to make happen. Edit: zip code 43062, age ~30, income too high for any help.
submitted by /u/patzor [link] [comments]Read Morer/HealthInsurance