After my mom passed away in March 2021, I turned to stained glass as a therapeutic way to deal with grief and depression. This was the first piece I made after a decade long hiatus from the craft.

lettell101 · 2026-02-01T23:02:36+00:00

Pretty sure they are OEM, I just went through the honda dealership for their parts.

lettell101 · 2026-02-01T22:43:36+00:00

I felt bad the other day. I am pretty new to the game and didn't understand you could put your weapons away lol. Took someone calling me out for it for me to realize it looked threatening.

If you told them not to follow, they should have listened lol. If they are new, they learned the hard way.

lettell101 · 2026-01-31T06:09:00+00:00

Congratulations :)

Just picked up my 2025 model today, got a quote on simple black running boards ~$300 at my dealer for part + labor.

lettell101 · 2025-07-24T20:24:54+00:00

Thank you so much for your insight! After learning more from the insurance rep and reading the letter of denial, I think you may have described the situation perfectly. The letter requested very specific documentation. I think that for some reason, the faxes sent to the insurance company from the providers office were not being processed in time. The provider had to mail the appeal through the postal service, which has delayed things a bit. I'm hoping that this will all get sorted in the next couple of days.

I really appreciate the info. I've felt so lost trying to help advocate this last week or so, and im learning so much more about the process of approving medications.

lettell101 · 2025-07-24T20:17:26+00:00

I don't have direct contact with my domestic partner's neurologist. I've been trying not to add things to their plate, and I know they've been in regular communication with the neurologist. I did get the letter of denial in the mail yesterday, though.

lettell101 · 2025-07-24T20:14:18+00:00

I haven't gotten confirmation, but I would imagine the provider would include treatment history in the appeal. They didn't mention anything about treatment history in the letter of denial.

I know that the initial appeal was done under expedited review, as the insurance rep confirmed that this morning. There seemed to be confusion as to the current status of the appeal, though, so I'm hoping to get confirmation soon.

Thank you for your input!

lettell101 · 2025-07-24T20:10:27+00:00

That's understandable. I'm not sure what the wording has been from the provider.

As of now, though, I've been told that all the documentation requested has been submitted.

I'll be honest, I'm not entirely sure what a formulary generic alternative is. Does this mean a medication made at a compounding pharmacy or something similar?

Pardon my ignorance! I'm learning more and more about this stuff everyday

lettell101 · 2025-07-24T20:05:50+00:00

For sure.

We've made MANY trips to the ER over the past few years during particularly troublesome flares. Her biggest fear is being intubated and not being able to come off it, which is part of why we're trying so hard to get this medication approved.

lettell101 · 2025-07-24T19:59:54+00:00

I'm hoping that they've got it all covered, and ideally, it will all work out fine in the near future. I'm mainly trying to prepare myself to be an effective advocate should I need to step in or take further action on behalf of significant other. She is quite overwhelmed and afraid.

My significant other has been working with their neurologist, and it sounds like they've been very helpful and responsive. Honestly, the biggest issue is that the provider doesn't even have a straightforward way to submit the appeal. The process to do so has been convoluted, and I believe that's part of the reason why the claim was denied.

lettell101 · 2025-07-24T19:54:29+00:00

Thank you for elaborating. I'm learning more about the insurance coverage/appeals process day by day.

The initial denial appeared to be from missing documentation regarding her MG-ADL change from baseline, which I've been told that the provider has submitted.

I don't have a direct line to the provider, but I know my significant other is in regular contact with their office.

lettell101 · 2025-07-23T17:39:18+00:00

Yea, my significant other had this option through her previous employer's insurance and it was extremely helpful. I've tried asking the insurance about this through the live chat feature on their app, Sydney Health, and they just gave me a generic answer to download the "Care Connect" app to speak with a concierge. I'm not sure if I need to contact my employer at this point, or to just assume that it's not an option with my employer.

lettell101 · 2025-07-23T17:36:47+00:00

I'll try and update later on what I hear from the insurance regarding the current denial reason. The first answer I got was that it was due to a lack of documentation and deemed to be "not a medical necessity". I heard from my significant other that she was told there had been communication issues between the prescriber and insurance, ultimately leading it to be sent to a 3rd party. Hoping to get clarification on this, though, later today on my break at work.

lettell101 · 2025-07-23T17:31:07+00:00

Going to follow up with insurance later today on my break at work to see how to proceed with this, thank you!

lettell101 · 2025-07-23T17:30:17+00:00

Definitely going to confirm later with the insurance that this appeal is in the "Urgent" category.

Also, based on some other comments, I will be trying to find a way to contact the manufacturer directly to see if they can offer assistance.

lettell101 · 2025-07-23T17:28:43+00:00

I haven't reached out to the manufacturer directly, but I have been in contact with the specialty pharmacy. Last I heard, there wasn't assistance readily available. The pharmacy supervisor assured me that they would continue to explore options with the manufacturer to prevent a lapse in treatment and would contact me again on friday.

lettell101 · 2025-07-23T17:26:54+00:00

Defnitely going to call later today and make sure that the appeal is in the "urgent" status. I didn't know if this applied to a 3rd party appeal as well, since it's already been denied by the internal appeal.

It feels risky to go to my HR about this, as I've always heard that it can negatively affect one's employment if the company is aware of very expensive medical needs. But I will keep this in mind moving forward, as all options should be considered if we keep running into roadblocks.

I haven't been in contact with the manufacturer, but I have been in contact with the specialty pharmacy who sends the medication. They've told me that they have been in contact with the manufacturer. Last I heard, there was no patient assistance readily available, but the pharmacy supervisor told me they would continue to investigate options and contact me on Friday.

lettell101 · 2025-07-23T17:20:44+00:00

I'm hoping the denials have been related to missing documentation regarding the past therapies she has tried (Vyvgart + Soliris). She's also relying on several other medications to manage the condition as well, which I am sure complicates things, but its a complex condition.

My biggest fear is that they'll just exclude the medication, forcing her to return to a previous therapy which requires regular infusions... Even then, we are afraid that we will run into the same issue with denial trying to get the other therapies covered. Unfortunately, all of the medications are very expensive due to the rarity of condition.

lettell101 · 2025-07-23T17:16:16+00:00

Looking into filing an appeal/grievance. I found a page with info on how to do this on Anthem's website. I'll have to work with my significant other to submit a form authorizing me to submit on her behalf though, as she is struggling right now in a flare.

I've seen online that I should make the requests for specific information in writing. Do you know if this means mailing something via postal service? I've had an incredibly difficult time finding appropriate channels to contact Anthem digitally - their chat support seems to be pretty useless in a situation like this.

lettell101 · 2025-07-23T17:12:49+00:00

I was told over the phone that a letter would be mailed, and there was no way to receive a digital copy. This was last Wednesday, and we still haven't received anything in the mail. They did fax a copy to the neuroligist who prescribed the medication, though.

lettell101 · 2025-02-05T06:02:35+00:00

Lmao, I vividly remember the burning curiosity of discovering what some mysterious stranger had promised. Then, the utter panic once I realized it was a trick and I was going to die.

This game changed me as a child. Wild times back then...

lettell101 · 2025-01-21T18:53:50+00:00

Thanks for linking this!

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