I have Crohn's disease, and I'm on some strong (and fairly expensive) medication. The company I worked for used to have us covered by Cigna, and the cost out of my pocket was $20 every three months. It seemed fairly reasonable to me for something that would otherwise cost $5,000+. We switched to UnitedHealthcare a month ago, so I had my gastrointestinal doctor do all the paperwork to get me set up under United's pharmacy. I even received a call from the pharmacy saying that they could ship me out a refill of my prescription whenever I like (I mentioned that I already had 3 months worth in my fridge from Cigna, and they said that they couldn't give me a refill until I used most of that up. That also seems reasonable to me).
So today I received a letter from United saying that I'm not eligible for my medicine, and that my prescription has been declined. WTF? I have 180 days to make an appeal (which I plan on doing) and I have a number to call next week to discuss this with a pharmacist. The letter very nicely states that I still can receive my medication, but I'll be responsible for the full (or additional!) cost.
I'm hoping that it's something as simple as "you have too much at home already, try again in a couple of weeks" but I'm going to try not to hold my breath over it.
I'm going to go make dinner and hope that helps me calm down...
United health sucks big time. I have them too and seems you really have to go thru the hoops to get it approved. They are jerks
Pre-existing conditions have to be covered under the Affordable Heathcare Act. To deny you access to your medication is to deny a pre-existing condition.
Quote from: Rachael on February 01, 2013, 08:34:11 PM
United health sucks big time. I have them too and seems you really have to go thru the hoops to get it approved. They are jerks
The only good thing I've heard about United is that they give better rates to the company I work for. I never had a problem with Cigna, but United and I seem to have started off on the wrong foot. What really has me confused right now is that I thought I had it all approved and now it sounds like they've changed they're mind.
Quote from: Ms. OBrien VT on February 01, 2013, 08:50:41 PM
Pre-existing conditions have to be covered under the Affordable Heathcare Act. To deny you access to your medication is to deny a pre-existing condition.
Right. I need to talk to them about this and find out what exactly is going on. At least I have enough medicine to last another 2 months in case things get dragged out (I'm really, really glad I refilled before everything switched).
It turns out things weren't as bad as I thought. My medicine was initially denied, and then they sent out the letter to inform me before my doctor sent in a second request that was approved. I guess United is too quick with their bad news letter mailing...
I'm glad it worked out. One of my daughters has Crohns, and gives herself a Humira injection every two weeks.
Quote from: Pleasingly Plump Jamie D on February 06, 2013, 04:05:41 PM
I'm glad it worked out. One of my daughters has Crohns, and gives herself a Humira injection every two weeks.
Oh, hey! That's the same drug and schedule that I'm on! It's worked really well for me the last 5 years, I hope your daughter has seen similar results :).
I hate health insurance companies with a passion because of stuff like this. I've been on united before and they did not want to pay for anything without having a fight first. I guess they make more money by seeing which of their insured will be discouraged and go away when told "no" the first time.