Rejection letter from Janssen CarePath re Spravato

Posted by Shirley Hugh-Jesst @audriana, Sep 1 11:07am

Dated 8/25/21 I received a rejection letter from Janssen Care-path Savings program…
ineligible…due to:
X. You currently do not have commercial or private health insurance…this program is not available to individuals who use any state or federal government-funded Healthcare program…"
Ironically, I do have State Employees Health plan, plus Medicare & Tricare…so much insurance and yet so many obstacles. The image of the letter isn't clear, so don't worry about it. It just says, "blah, blah, blah, blah-blah."

Hi @audriana, form letters are usually short on details and not personal. It gets so exhausting to continue to advocate for yourself, but I'm afraid that's what you might have to do … again. I read in your bio that you are an advocate and an educator, so I know you can do this. Can you contact a Janssen CarePath Care Coordinator and explain your insurance status? Clearly they don't have the correct information.

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@audriana I received the same confusing letter. It just means you don't qualify for payment assistance for the medicine. You already have your own insurance, thus you don't qualify for their assistance program. NC State Employees /Medicare/ Humana covered my Spravato, no problem..

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@clutch @colleenyoung hi! I took the letter to my psych appointment today. We mutually rolled our eyes because it was so confusing.. We figured it was something automatically processed. As @colleenyoung said, form letters are not personal.
Clutch–you mentioned Humana…smh…I was told by Humana that Spravato was not in the 2021 formulary, so I opted for BCBS 70/30…another complication.
Onward and upward! Thanks for the info and support…
6:35 pm, I just got off the phone with Andrew. Today, he spent 3 hours working with the insurance companies. BTW, he confirmed that Spravato is in Humana's formulary now.
Last week, I was on the phone with Medicare for an hour and 58 minutes…whew…yes, advocating is indeed necessary
Sometimes it's just really difficult when my brain is malfunctioning…

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@colleenyoung

Hi @audriana, form letters are usually short on details and not personal. It gets so exhausting to continue to advocate for yourself, but I'm afraid that's what you might have to do … again. I read in your bio that you are an advocate and an educator, so I know you can do this. Can you contact a Janssen CarePath Care Coordinator and explain your insurance status? Clearly they don't have the correct information.

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@colleenyoung, you're absolutely correct. The information was inaccurate–so many glitches. A woman from Janssen–Veronica–is supposed to contact me.Apparently, even she is confused as to what is going on with my case. I have people in my corner and I appreciate their efforts.

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@audriana

@colleenyoung, you're absolutely correct. The information was inaccurate–so many glitches. A woman from Janssen–Veronica–is supposed to contact me.Apparently, even she is confused as to what is going on with my case. I have people in my corner and I appreciate their efforts.

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Best of luck, Shirley. Sending you patience and fortitude to keep at it until you get answers. It's not easy being a patient.

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I know Spravato is more expensive. I found a provider that does ketamine treatments which are less than half the cost but still not covered by insurance. Just FYI. I am feeling some relief as I am still in the initial phase of treatment.

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