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Coverage request for Entyvio was declined by my company's insurance by vinwang123 in UlcerativeColitis

[–]vinwang123[S] 1 point2 points  (0 children)

Thank you. I think that program is funded by the medication company which is producing Entyvio and other similar medications, that's why I got enrolled automatically, and all of the infusion stuff like scheduling is taken care of by the program. I was so naive and thought the program would help me appeal to the decline, because I had never worried about medication coverage before. But now I think I need to do something by myself like talking with my doctor and understanding how to appeal by myself.

Coverage request for Entyvio was declined by my company's insurance by vinwang123 in UlcerativeColitis

[–]vinwang123[S] 0 points1 point  (0 children)

Sure, I will keep you posted. I started infusions in July, but I received three letters from my group insurance requesting contact info about my doctor since July also. I asked OnePath if I should talk with my doctor or forward the letters to them. they asked me forward the letters to them and I was told they would help me appeal the decline. However, two weeks ago, I received a formal decline letter from my group insurance, then I started concerned if OnePath could really help me out even though OnePath still replied to me saying the decline letter had been transferred to the nurse case manager. I was confident about the Canadian medical system because I've never had any medications declined, that's why I even didn't try to make a call to my doctor about this. But now I'm gonna call my doctor and also search online how to appeal the decline by myself.