Just wondering how they are with approving medications? Our insurance is changing Dec 1st. We're moving from Aetna, which denied a lot...
Posted by sammy (Member # 13952) on :
My Anthem plan was good for oral meds. Needed some prior auths for blatantly necessary meds not related to Lyme. They were eventually approved with help from my doc.
There were a few meds that had quantity restrictions like factive, had to buy it every 7 days. Bicillin was restricted but it was almost a month supply.
They covered 4 weeks of rocephin due to verified neuro Lyme. My many doctors and lawyers lost 5 levels of appeals and were unable to get further coverage.
I've had to see countless specialists, needed expensive tests, and even surgical procedures within the past year. They were all covered without a fight.
I've had Anthem for about 6 yrs now with a brief bad year mixed in there with united healthcare.
Honestly, I would chose to keep a good Anthem plan over any other.
My family members have had much worse experiences with other supposedly "great" plans through Cigna and Humana.
Unfortunately, I have to switch to Cigna on Jan1, no other choice. Guess we'll see!
Posted by FamilyFive (Member # 37206) on :
Thanks sammy. I appreciate your feedback!
Posted by SouthPaw (Member # 35229) on :
I've been on Anthem BC/BS for 7 years. I've never had any problems. My doctor had to submit additional paperwork to get more than 14 Lunesta per month but they OK'd it till 2034!
I just started my fourth month on Rocephin. They only pay for 28 days for Lyme but extended it indefinitely because of Babs/Bart. A bit of a loophole on their part, but get the impression most don't get so lucky.
Posted by granniela (Member # 17134) on :
I've been on the Anthem BC/BS for years. The only time I've had problems was when Medco was the contractor for the mail order pharmacy program. They denied things and it was Medco doing the denying, not BC/BS. Since they lost the contract, there haven't been any problems for what I'm taking through Caremark/CVS.