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Starting Arikayce - nervous

MAC & Bronchiectasis | Last Active: Apr 15 10:36pm | Replies (120)

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@kathyjjb

Thanks Laurel,
Okay, so Customer service said it wasn't on Humana drug list. Ugh.
Kathy

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Replies to "Thanks Laurel, Okay, so Customer service said it wasn't on Humana drug list. Ugh. Kathy"

I'm on Humana Value Rx in Tennessee and it is covered on the formulary. When I did my research, UHC, Humana and Cigna covered it, but Cigna dropped Vanderbilt from their pharmacies. I had Cigna when I was on Arikayce in 2023-24. Now, I'm on straight Medicare -- Plan G with Plan D supplement. I was diagnosed with BE/MAC accidentally and thankfully before I turned 65 so I knew I would want the strongest, most comprehensive Medicare coverage I could get. I'm grateful for that timing because I would have likely done an Advantage plan since I was healthy as a horse.

Maybe your doctor can can request an exception with Humana? Based on what I'm reading, it's at least possible to get a drug that's off formulary approved. If they deny the exception, you can then file an appeal of the denial. But also find out about any grants or assistance that may be available. Best of luck!!