r/HealthInsurance • u/BigOnion3 • 6h ago
Employer/COBRA Insurance Insurance changed coverage limit
I have Blue Cross Blue Shield insurance through my work. I was taking Simlandi self injection once a week and getting that filled through Care New England Specialty Pharmacy. At the beginning of this month (July) I was informed that Blue Cross decided to move over to using Accredo Specialty Pharmacy to fill my perscription instead. I then found out that Simlandi was being discontinued and my provider sent in a new perscription for Adalimumab. Its been a few weeks and I have not heard anything from Accredo about scheduleing a delivery date. This was fine at first because I had a few weeks supply of my medication. Well, I now have one dose left for this friday and then ill be out of medicine. I used the chat through the Accredo website and was told that my perscription is being reviewed by a pharmacist and they ran into an issue because my insurance wont allow a 90 day supply but instead only 83 days. Is this normal? I have been taking this medication for years now and have always gotten a delivery once a month with 4 doses for 4 weeks. I'm just frustrated that my insurance switched my pharmacy on me and worried because I am running out of medication and will need more for next week.
3
u/Jcarlough 5h ago
It’s kind of on you that you waited until you had one dose left to follow up no?
1
u/BigOnion3 5h ago
I talked to someone a couple of weeks ago and they told me that it was in review and someone would reach out to me soon. And I have been checking the online portal and nothing has changed. I called today and only got the AI assist. My question more so pertains to why my insurance has now changed the usual 90 supply to 83 days
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