I need to sign on with an insurance company after my cobra runs out. I live in California and have been considering Assurant Health Aetna Signature Administrators PPO. Does anyone have information regarding the coverage of immunoglobulin (Ig) therapy with Aetna PPO, and whether Ig therapy is subject to a restrictive formulary? I have been receiving 25 grams of Ig once a week for over 10 years and want to ensure my therapy continues. Does Aetna PPO cover nursing visits and supplies? Are there annual limits on the number of nursing visits? Also, any information regarding the authorization process would be greatly appreciated. Thanks and stay strong!
I too recently converted from COBRA (April 2014)- what I did was contact my pharmacy/nurse (CORAM - a division of CVS) and asked them which insurance company provided the best coverage for CIDP - their answer was Neighborhood Health Plan (we are in Massachusetts). I have had no problem/interruption and my therapy has changed 4 times (increased in frequency & dosage) in that time. CORAM handles all of the authorization process as well. My PCP recently told me that she thinks my premiums will ultimately rise - we will see. Don't know if this is helpful but hope you will experience no issues !
This is a good reminder to any of us who are shopping for insurance. You have to be so careful.
Many people unfortunately fail to dig deep into the details and that mistake can be very costly.
When my COBRA ran out in early '14, I had to find an Obamacare policy for my wife and I. I ended up with a $1300/month policy because that was the best fit considering deductibles, copays for Dr. visits, coverage for testing, and the drug formularies.
The Social Security Administration put me on Medicare starting Jan 1, 2015 (this is automatic after being on SS Disability for 2 years,BTW), which is admittedly much cheaper, but not wthout pitfalls. You have to search out and purchase a Medicare Part D policy for your RX coverage.
I have been on Mycophenolate (cellcept) which is a powerful immuno suppressor. This allows me to take a lot less prednisone. In shopping for policies, I verified that Mycophenolate was on the drug formulary, although it was listed as a "specialty" drug. I expected the cost to be a little higher because of that classification.
Unfortunately, that drug is primarily used in organ transplant recipients to fight ogan rejection, and that is the only use that is recognized by the FDA. CIDP is just to obscure and off of their radar screen. It was denied, my DR. appealed, it was permitted for one refill, after I had been out for three weeks, then denied again. After another appeal by my Dr, it is supposedly approved but needs "Prior Authorization", so again, I'm out of the drug. This has put my slow taper off of the steroids on hold and is making me paranoid about relapsing. I may have to increase the steroids if things start to go downhill. Meanwhile, I'm fighting back by swimming laps and weight lifting for strength.
I don't know how the insurance companies treat the IVIG drugs, but if you are still shopping, be very diligent about downloading and searching those formularies!