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Humana provides my medical insurance for prescription meds. Although Biktarvy is in their formulary list of approved drugs it will now require a written Prior Authorization (term from Humana) be on file with them at least two weeks before 1/1/2020 to be covered for insurance.
Looks like the Centers for Medicare and Medicaid Services (CMS) have implemented the following 2018 proposed Trump Adm Cost Reduction and Savings Plan :(
https://www.statnews.com/2019/01/24/medicare-ch...
I just wrote CMS to clarify if the proposal was approved and is being implemented on Jan 1, 2020. But is sure looks like it based on what Humana is now requesting from me.
Fight for biktarvy it is now a preferred medicine for HIV. So denying it should be hard for them to justify.
If I remember right when I first got put on the meds I had to get one but I have not had to after that I hope the same will happen for you.
The administrator of the ADAP program (called HDAP) here in Hawaii said to not be worried because in worse case he would cover the full cost of my HIV meds even if the insurance is unwilling - currently HDAP is my secondary for medical insurance related to medications so anything unpaid automatically rolls over to them, even things like my psych meds as Hawaii is extremely generous. They even have all of my meds delivered to my home via UPS.
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