B
bethylove
Guest
For over the past month(s) I've been calmly twiddling my thumbs waiting on news about kayldeco. I DO have the g551D mutation and filled out my paperwork in febuary.
A call from Vertex and they sent off the script not 100% sure of what my insurance would require (i.e. prior authorization, appeal, etc. ) Well, an appeal was neccessary since they didn't want to cover it. Appeal went through. Then the pharmacy calls to tell me they're waiting on a prior authorization. (Fast forward two weeks) And the pharmacy calls again to inform me there's another problem and that my insurance company won't cover it for at LEAST 6 months. They claim since it's not on their formulary it's not covered.
GIANT UGH! I feel so frustrated right now. ESPECIALLY since I see other people without the mutation who have been on this drug for over three weeks. I understand there's no way to know how this drug affects all the mutations (there are so many of them!) but still! To come here and see that all because of my insurance I'm stuck wihtout the drug - for what they tell me months!- while other people are just fiddling around with it in the hopes that it may do something. . . it's frustrating.
I feel that ever since I've turned 18 its been one ordeal or the next with insurance companies. Don't get me wrong. I LOVE THEM. I'd rather go through this ten fold than have to pay the 300k price tag of the new drug. But that doesn't make it any less frustrating.
I can't be the only person under Blue cross blue shield of RI who has this mutation and is eligible for this drug. And of course its not on the formulary you twits it JUST got approved. BLAH. I hate the fact that paper pushers are playing god with people's lives here. SO FRUSTRATED!
End of vent.
A call from Vertex and they sent off the script not 100% sure of what my insurance would require (i.e. prior authorization, appeal, etc. ) Well, an appeal was neccessary since they didn't want to cover it. Appeal went through. Then the pharmacy calls to tell me they're waiting on a prior authorization. (Fast forward two weeks) And the pharmacy calls again to inform me there's another problem and that my insurance company won't cover it for at LEAST 6 months. They claim since it's not on their formulary it's not covered.
GIANT UGH! I feel so frustrated right now. ESPECIALLY since I see other people without the mutation who have been on this drug for over three weeks. I understand there's no way to know how this drug affects all the mutations (there are so many of them!) but still! To come here and see that all because of my insurance I'm stuck wihtout the drug - for what they tell me months!- while other people are just fiddling around with it in the hopes that it may do something. . . it's frustrating.
I feel that ever since I've turned 18 its been one ordeal or the next with insurance companies. Don't get me wrong. I LOVE THEM. I'd rather go through this ten fold than have to pay the 300k price tag of the new drug. But that doesn't make it any less frustrating.
I can't be the only person under Blue cross blue shield of RI who has this mutation and is eligible for this drug. And of course its not on the formulary you twits it JUST got approved. BLAH. I hate the fact that paper pushers are playing god with people's lives here. SO FRUSTRATED!
End of vent.