I am having significant issue getting medication approved from my insurance. They are constantly saying it’s not medically necessary and are having me try many other options before considering the ones initially recommended. Has anyone dealt with this? I feel like their denial is going to leave me many years without remission, and that I should be able to press charges for them causing me physical, financial, and mental harm. Am I over reacting? I’m just very tired of insurance not permitting what doctors prescribe, it seems like something that shouldn’t be legal. Any tips on navigating this?
Crohn's Disease (IBD) Inflammatory Bowel Disease
Make sure your dr is persistent. The insurance never wants to pay for my Humira but he pushes it through and insists I have to have it and they finally give in. It's a Neverending cycle. Good luck.
Yes...and I had to do the dance. First year I took Prednisone, it was covered by insurance. In another year that I needed it again, I had to take budesonide instead as the "preferred" medication as Prednisone wasn't covered anymore. When budesonide wasn't effective, even after higher doses, I was then permitted to take Prednisone. Of course my flare continued during this process, but once my doctor could write that budesonide was ineffective as a treatment and that Prednisone was the only reasonable next option, did insurance approved it.
My mom would always have to fight with the insurance test for like blood tests and stuff even to get covered. Made me afraid to deal with insurance like that myself so I avoided doctors as much as possible after that...
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