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I was told by Highmark, just this week, that my co-pay for a three month supply of Triumeq would be $330.55. My doctors office called the insurance company to try to get the co-pay lowered but insurance refused. I hope they lose this suit and are fined for their discriminatory actions.
I have cigna and a Platinum plan which has very expensive premiums but it makes my meds $150 out of pocket fortunately i have a co-pay assist card which reduces it to zero. At this point in my life I can afford the premiums however as i enter retirement i do not know how i will make it meds designed to save our lives and it is all we can do to afford them
CVS Caremark refused to cover Genvoya, in the place of Stribild. Despite it being less toxic. The whole situation took over a month for me to finally give up trying, by that time I had run out of meds and was forced to return to using stribild, despite my doctors reluctance.
How do you go about forming a complaint? I had a huge issue with Cigna not covering the medication Odefsey, which is going to be replacing the drug Complera come fall due to less toxicity. They refused to cover the med and I battled with them for a month. And also was rationing out what medication I had left because I had no idea when I would get a drug sent to me. Absolutely ridiculous!
HealthFirst NY also discriminates - they refuse to pay for the improved version of "Truvada" that was released under the drug name "Descovy" even though everyone in the healthcare community is aware that the scientific studies that were done for the release of "Descovy" showed that it is 90% less toxic than "Truvada". They hide behind the excuse that it is not in their 'formulary' which is their predatory code-speak for 'too expensive regardless of the benefits to the patient.'
mwarriner
Why wasn't Healthnet sued? I'm on a Medicare HMO thru Healthnet. They raised my copay from level 4 to level 5 at the beginning of this year, which bumped my copay from about $100 per month to nearly $900 a month. Thank goodness I'm on Medicare. The increased copay immediately bumped me into the donut hole and almost as quickly, out the other side, which leaves me back at a little over $100 for the remaining 9 months of the year. But I'll have to start over again next year.
September 9, 2016 • California