On Saturday April 22, 2023 i was in Alexandria VA with the National Psoriasis Foundation for their annual conference.
These conferences mean alot to me as I get to not only learn many things but catch up with others who have many of the same issues as me. Not only medically but dealing with insurance and laws etc.
One of the topics was on Step Therapy. This is where the insurance company wants you to try drugs X & Y before they will allow you to try Z. In working with Congress there are now laws in many states against this, however, they found a loophole and it continues on.
I also had an issue in 2021/22 , with step therapy. The laws have been passed in New York and I was part of that. So when my Dr said he wanted me to try a new medicine and saw Aetna prefers it, he prescribed it. Dr Aetna shot that down too, but knowledge is power. When I called Aetna, they said I needed to try two and fail two triptans first and I only tried one, I said that’s step therapy and is illegal in the state of new york, second the Dr said they no longer prescribe triptans to males over 50 as it causes cardiac issues. The woman stopped the conversation and asked for the Dr to call and gave me the 800 number. This was on a Friday, I was approved and had my meds on Monday.
I also had another issue that i believe falls in this same category this weekend and it really pisses me off.
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