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Medical insurance denying Qulipta for migraine
My neurologist tried to get me approval for Qulipta for a daily persistent headache for 5-1/2 years and my insurance is denying it because it is a Medicare Advantage plan. Qulipta was even willing to give me a $0 pay card for it. I had to try several other migraine meds first which I did and still, no coverage. Nurtec is $552 for 16 pills with insurance. This isn't even realistic.
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I am very sorry and saddened to see your posts and others like it so early in the year. Is that card with 0 copay still an option? I did in the past research Canadian pharmacies but never went any further. Is this an option?
I have a warning to all about something that has happened to me. I began origional medicare on 1/1/25. My SSA deposit lacked a full deduction for my part B premium. The deduction was 124.00 not 185.00 I called SSA was on hold over 4 hours. I was told they show a part B premium deduction but saw no organization responsible for it. I had humana choice ppo medicare advantage all of 2024.The last day for me was 12/31/24. The plan gave me a part B reduction of 55.00 per month. The amount that my premium was reduced was 61.00. This is incorrect. I have a letter from hunana showing my plan ends on 12/31/24. I enrolled in aarp united healthcare earlier this fall when open enrollment began. I changed to origional medicare and I have a letter from aarp confirming it. I wasted no time with this. I filed a complaint with OIG. I reached out to one of my senators in my home state. They are helping me. SSA on my behalf escalated this to the processing center. I cannot get a phone number or email for the processing center. Next month and every month this error occurs I will hold back 61.00 because medicare and social security have clawback. I have had many awful situations with medicare advantage but nothing like this with SSA. SSA said the deposit is a month behind but medicare is a month ahead.What gives here?
I am signed on with IDme so I monitor my SSA and I also have a pension with opm so I monitor it as well. I also have an account with medicare.gov. I am considering joining a direct primary care practice for 59.00 a month. I of course have to keep medicare but I would be out of this " system" some with a direct primary care practice and able to discuss and decide with my doctor the best treatment plan with no corporate or govt meddling. I pay for my own prescriptions myself. I get a discount and they are mailed to me free. Remote area medical is coming to my state in March. They provide free dental care vision exams and glasses and primary care. No cost. I have used them before. You do wait overnight in a parking lot. They start the next day at 0600. I am disgusted by the healthcare system which has become all about profit and control.