Know Multiple Sclerosis

I would like to know how you can fight an insurance company re: medications. I have BCBS of SD they will pay for the medicine but it is not on a tier. I am considered major medical therefore, you need to meet the deductibles first. I know other insurance companies will put this on a tier so you don't have to come up with this kind of money up front. If anyone has an answer I would really appreciate it. Thanks

I'm not an expert in this area, but I would try a few things.

First, I would approach my own insurance company and explain to them that most other insurance companies offer this drug on a tier, and see if they are willing to work with me on the cost.

Then, I would go straight to the drug company. I'm not sure which drug you take specifically, but most big drug companies offer financial assistance for expensive drugs (such as the ABCR drugs). They want you to be taking their drug, and want to help you find a way to do it. You have more leverage with them than you think. For drugs with a very specific target (such as an MS drug), the market to which they are selling is very limited - which gives us more leverage.

I personally think going to the drug company is more likely to get results.

Another thing to look at is another insurance company. If your company has an open enrollment every year, take a look at the other options to see if there are better ones. There is usually a way to reduce the cost of these expensive drugs - I would just try from a few different angles.