Raptiva and Insurance

[MGL]

I tought you all might want to know about my experience trying to get a Rx for raptiva through my HMO. I have just come out of a research study for the last year or so. In the middle of the study, I changed insurance and entered an HMO that I had belong to several years ago. I met with my Derm this week to see about continuing on Raptiva. The answer I got would make the government or the military proud! In order to be approved, my skin would need to be REALLY bad! Since Raptiva has made my skin REALLY good, I don't need Raptiva!!! Before it can be approved, all other treatments need to fail. Evidently, my experiences with other treatments in the past, including my experiences with the HMO for the 10 years they treated me, do not matter. What matters is that my skin is too clear! I plan on appealing the decision. If anyone else has any similar experience or any ideas that might help in an appeal, please let me know.
Thanks!

Mark

[Kimbercat]

typical government response! (this from a government worker!) :rolleyes:

You might try contacting the NPF Advocacy Dept for assistance. Sometimes they have forms and letters that might help you give the process a good swift kick in the rear. Good luck. :)