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insurance denial

  • By Nan Hart

    so here I am three weeks waiting now with two denials for a new medicaton and having met the insurers criterea feeling horribly frustrated…doctor says he will keep trying but in the meantime my flare and the accompanying pain are escalting…thoughts or suggestions welcome…Nan

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  • By Andrew Lumpe, PhD Moderator

    Nan, so sorry to hear that. Getting denied, no matter what for, can be very discouraging. Does your insurance company have an appeal process? Have you talked to your doctor about what to do in meantime? My rheumy suggests that I take prednisone for a short term to knock things down.

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  • By Mariah Z. Leach Moderator

    Hi Nan~

    I don’t know what medication you are trying to get access to, but you may want to look and see if that medication offers a co-pay assistance program that could help cover some of the cost. For example, when I was on Remicade I used a program called RemiSTART to help afford it. And Enbrel has a similar program. So even if your insurance will not cover it it may be possible to get a different source of help. I recommend googling the name of the medication and “co-pay assistance” to see if there are any other options.

    Best of luck!

    ~Mariah~

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