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Medicare and Kevzara approval 2026
Hello, Has anyone on Kevzara and on Medicare successfully had their Kevzara added to the formulary in 2026?
I don't believe any Medicare Rx companies cover Kevzara without the doctor adding it to the formulary/ requesting prior authorization.
I've been on it successfully for at least 18 months.
Last year I had AARP UHC Rx & once the doctor sent in the form it was added immediately. This year my broker had me switch to WellCare and they turned it down after my doctor sent in all necessary documentation. I'm wondering if it's the company or if it is more difficult this year.
I have been on Prednisone & failed terribly. My doctor is attempting to continue the fight.
Thank you
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I had no problem….my RX supplemental United Healthcare has not chged . My Rehumy practice has a pharmacy in it.
@tweetypie13 I knew I shouldn't have changed my insurance, my broker pushed me to. My rheumatologist is affiliated with a large hospital and they also have their own specialty pharmacy, I never had a problem before. Thanks
@marci516
Like everything else, it may take many phone calls. Be relentless, it’s your health, and sadly no one fights for,you as hard as you. 👍
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1 Reaction@marci516 You might be able to switch back. Its not as easy as during the the open enrollment. I am hoping for that my results are not the same. I had UHC. my monthly premium went from $87 month to $146 so I decided to switch. I have Humana now at $3 month but my co-pay is higher. I take a drug called Repatha for familial cholesterol. Waiting on approval.
@tuckerp that is exactly why I switched, my UHC premium had increased so much and the WellCare was much lower. I did as the broker advised. I’ve already asked her if I can switch back & was told “no”. I will follow back up with the doctor tomorrow & if she hasn’t made progress I will contact Medicare myself. As @tweetypie13 said we must advocate for ourselves. Good luck & thanks!
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1 ReactionI have humana and the approval to add was same day. I almost switched to wellcare too,, imm glad I didn't. I found a humana plan for 10 / month. Which seems to be working well for me.
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1 Reaction@tuckerp
Does Repatha work for you?
My adopted daughter has familial hypercholesterolemia and was on the highest dose of rosuvastatin and her LDL was still too high. Now her doctor has added Zetia (Ezetimibe) which is what I take instead of atorvastatin. My daughter seemed to think she should stop her rosuvastatin when I stopped atorvastin until her cardiologist found out.
My adopted daughter is so much like me. We both have faulty genes but not the same genes. She doesn't want my genes and I don't want her genes.
@dadcue thank you but my cholesterol is fine. I don't believe those are meds for PMR. Best of luck yo both of you.
@marci516 Look into the 'birthday rule' for Medicare. You can change your supplemental, outside of the enrollment period. Each state has it's own rules.
Those of you talking about the UHC premium, isn't that your supplemental? It shouldn't impact your Part D. I have UHC supplemental and WellCare for my Part D. They don't impact each other.