POZ Community Forums
Meds, Mind, Body & Benefits => Insurance, Benefits Programs & HIV => Topic started by: Peteskier on March 29, 2012, 09:29:10 am
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Today I received a letter from Cigna Insurance stating that the medication I take Atripla Tablet will now be considered a "Specialty" drug and after 07/01/12 they will not pay for it if I pick it up at the pharmacy. Instead I will have to get this medication from their mail order program. I requested a copy of the "Specialty" drug list to see just how many AIDs medications are on the list.
I have used the mail order pharmacy in the past and they have lost my perscription stating that they could not contact my doctor and mailed it back to me to which I never received it in the mail causing me to go off medication endangering my health.
By changing a drug classification mid year and forcing me to fill this drug through their home pharmacy delivery program in order for it to be paid for seems very discriminating.
Does anyone else have this problem with their medical insurance?
We need better laws to to stop insurance company discrimination!
Peteskier
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If you are in the U.S . and are on Medicare/Medicaid you can change your part D drug plan anytime you want to . You wont have to wait until the annual enrollment period to make changes if you wish .
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This "Specialty" tier is common place now. My insurance company pharmacy (Medco) used to provide me 90 day supplies of Truvada and Kaletra for a $60 Copay. Similar to you, one day they notified me those drugs were now in their "Specialty" classification and would need to be filled by a different pharmacy (Presription Solutions) and that they would only fill 30 days at a time for the same $60 Copay.
Overnight my Copays went from $120 for 90 days to $360 for 90 days. It was at this point, through the guidance of some folks on here, I discovered Copay cards and my cost went to ZERO :)
When I asked about the criteria for "Specialty" designation and why the change to only filling 30 days at a time, they told me the classification was based on the seriousness of the illness and cost of the medication. The reason for only allowing 30 days at a time was so together we could better determine if the drug was working.
HUH?? I had been on that regimen for 7 years at that time....it was working fine. I hope some attorney sees a class action opportunity in the clearly discriminatory practice. It's just this kind of injustice and greed by insurance companies Obamacare was supposed to help get after, but after the past few days Supreme Court hearings I'm losing confidence the bill will ever see the light of day.