Wednesday, November 2, 2011
My insurance has decided that Gilenya is too expensive to cover. They want me to try two other medications before they will cover it. When we looked up the cost of my potential medications it didn't list this requirement so that's fun.
I can appeal this decision if I want but the doctors have already appealed and lost. Even if I don't decide to appeal this means that the soonest I can get started on any medication will be in three weeks. And that would be if everything went smoothly. I'm really frustrated by this delay but I guess I should have seen it coming. The magic pill just seemed too good to be true. I don't want to start another medication but I don't think it is a good idea for me to delay starting a medication. I will have to wait until I receive the letter with more details before I can decide how to proceed.
Oh and my insurance is auditing me. They think that I have alternate insurance. I don't. I responded to their questions and was told that took care of it. When I was on the phone inquiring about why they had doubled billed some of my claims I was informed that I'm still in the process of being audited. Apparently they are auditing me because they think I qualify for Medicaid which I don't.
I think I'm beginning to understand why people call the company "Inhumana". So much for "guidance when you need it most".