General Discussion

sinkingfeeling

(57,342 posts)

446. Here's the 'Specialty Drug' list from Anthem BC - New Hampshire for MS:

Thu Mar 20, 2014, 09:28 AM

Mar 2014

Multiple Sclerosis
Ampyra
Aubagio
Avonex
Betaseron
Copaxone
Extavia
Gilenya
H.P. Acthar
Rebif
Tecfidera
Tysabri

To be sure the specialty drug is covered, call the specialty pharmacy at 800-870-6419, Monday-Friday 8 a.m.-10 p.m., Eastern time.

http://www.anthem.com/employer/co/f3/s3/t0/pw_b130446.pdf?refer=ahpprovider&state=nv&refer=ahpprovider&state=nv

They also have a eReview for clinical reviews:

eReview

eReview: New option for Pre-certifications/Authorizations

As part of our ongoing efforts at Anthem Blue Cross and Blue Shield to ensure you are receiving the best possible service, we would like to introduce you to a new, more convenient clinical review option called eReview. eReview allows you to send information to and receive information from us about requests for service via secure email.

How the process works: With just a click of a mouse, the Provider can send demographic/clinical information to Anthem via secure e-mail. The information is then received by an Anthem associate from a shared e-mail mailbox. The Anthem associate then processes the information and responds with the authorization decisions, including the authorization number, to sender via a secure link.

Getting started: All you need to get started is access to e-mail. See the information posted below on further details to get you started today! Information includes frequently asked questions, eReview Request form, and an eReview Information Sheet that includes screen shots that walk you through the process.

Attachments: Attach any medical records or notes to the eReview request. Again, all information is sent secure email to ensure HIPAA compliance. If you don’t have medical records electronically, you can still use eReview, and just fax in any medical records that need to be attached to 800-763-3142 and include you eReview information in the fax cover sheet.

eReview Welcome Letter

And here's a link to their document on how to expedite appeals:
http://www.anthem.com/provider/nv/f5/s1/t0/pw_e205625.pdf?refer=ahpprovider&state=nv

It starts on page 125 and says the expedited appeals will be done within 72 hours.

I hope this is of help to you.

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So let me see if I've got this straight... [View all] WilliamPitt Mar 2014 OP

Yes it is very interesting how this is a legacy legislation, djean111 Mar 2014 #1

"socialize losses but privatize profits" - could be the motto of our country now... polichick Mar 2014 #7

+10000000 woo me with science Mar 2014 #18

They're still too stupid or hateful to understand that simple message. Fantastic Anarchist Mar 2014 #258

It IS the motto. bvar22 Mar 2014 #191

I read recently ... Fantastic Anarchist Mar 2014 #260

Brilliantly done. Thanks polichick. n/t truedelphi Mar 2014 #441

That is a really great analogy. cui bono Mar 2014 #295

...^ that 840high Mar 2014 #404

Billy Tauzin pscot Mar 2014 #2

He was a frequent visitor during the writing of the bill. polichick Mar 2014 #3

And single-payer advocates were being arrested. Fantastic Anarchist Mar 2014 #262

Single-payer advocates were not allowed to be heard. Enthusiast Mar 2014 #313

Absolutely. Fantastic Anarchist Mar 2014 #322

Max Baucus, notorious blue dog. Enthusiast Mar 2014 #362

$$$$$ that's who runs it. 840high Mar 2014 #405

Tauzin’s $11.6 Million Made Him Highest-Paid Health-Law Lobbyist jsr Mar 2014 #373

And worth every dime to Big Pharma pscot Mar 2014 #406

Oh yeah, I remember this door swinger from back in 2005.... ReRe Mar 2014 #442

Whereas before the ACA the insurance companies would have paid for everything, no questions asked? geek tragedy Mar 2014 #4

Yes, thank you. mountain grammy Mar 2014 #43

No, the answer is to fight for single payer & next time don't be diverted by politics. Some things sabrina 1 Mar 2014 #94

Amen.... daleanime Mar 2014 #148

Yes because fighting for what couldn't be done is so useful.... VanillaRhapsody Mar 2014 #157

Nothing can be done Erich Bloodaxe BSN Mar 2014 #220

Some things cannot be done no matter how hard you try.... VanillaRhapsody Mar 2014 #221

Well, abolition of serfdom and slavery couldn't be done, too. Fantastic Anarchist Mar 2014 #268

Now we are fighting slavery again? VanillaRhapsody Mar 2014 #270

Are you implying that we stop fighting? Fantastic Anarchist Mar 2014 #279

No...did you read my posts before replying? VanillaRhapsody Mar 2014 #280

I did read your post. Fantastic Anarchist Mar 2014 #283

apparently not.... VanillaRhapsody Mar 2014 #285

Did you not say the following? Fantastic Anarchist Mar 2014 #290

Yes I said that....how is that twisted into what YOU said? VanillaRhapsody Mar 2014 #293

You really can't be that obtuse. Fantastic Anarchist Mar 2014 #297

this is the best flippant response you could come up with to cover your error? VanillaRhapsody Mar 2014 #474

What else could I say? Fantastic Anarchist Mar 2014 #475

Yes the Public Option...not just the ACA...DUH! VanillaRhapsody Mar 2014 #477

Huh? Fantastic Anarchist Mar 2014 #478

reading is fundamental my friend... VanillaRhapsody Mar 2014 #479

Indeed. Fantastic Anarchist Mar 2014 #482

My grasp is firm....I am not the one that jumped into the middle of a conversation VanillaRhapsody Mar 2014 #485

No one with at least 10% of their brain functioning would call that post disingenuous. cui bono Mar 2014 #465

Obama did not consider single-payer, simply because single-payer would never pass in Amonester Mar 2014 #433

You fail to understand my post. Fantastic Anarchist Mar 2014 #447

Exactly. cui bono Mar 2014 #466

And haven't you noticed that the defenders here ... Fantastic Anarchist Mar 2014 #469

Actually you start with stuff far beyond what you hope to get so that you get closer Lars39 Mar 2014 #472

Yes, you are correct. cui bono Mar 2014 #473

I missed a few episodes. Fantastic Anarchist Mar 2014 #476

It's from years ago, and I found it! cui bono Mar 2014 #481

I do remember that! Fantastic Anarchist Mar 2014 #483

We'll never truly know because he never tried. cui bono Mar 2014 #464

Well said Aerows Mar 2014 #289

My grandmother always said, 'you got what you fight for, if you're not willing to fight, you get sabrina 1 Mar 2014 #246

Yes because getting NOTHING for your efforts would have been soooo satisfying huh? VanillaRhapsody Mar 2014 #264

The good SHOULD be the enemy of the bad. My grandmother was totally for being the enemy of the bad. sabrina 1 Mar 2014 #436

'not audition for a Koch Brothers commercial' Whisp Mar 2014 #174

Thank you!! And don't put all you health care in one basket. MS is in my family (2 cousins) kelliekat44 Mar 2014 #335

The OP will blame his favorite whipping post come hell or high water and label anyone who Cha Mar 2014 #382

if he hadn't thrown a hategasm about the State of the Union speech's honoring geek tragedy Mar 2014 #383

Precisely. It's a nasty habit. Cha Mar 2014 #384

You've got that right. Before ACA it was all one big love-fest with the insurance companies... Hekate Mar 2014 #416

she has an awesome rheumotologist. can't be overstated how much that matters. geek tragedy Mar 2014 #421

So did your friend who told you "Screw it don't do shit" read that thread? snooper2 Mar 2014 #5

Screw it, don't do shit? WilliamPitt Mar 2014 #6

Thanks! my boss said so for my 2013 review a couple weeks ago as well! snooper2 Mar 2014 #10

But he was not telling you the truth. Different insurers use different formularies. pnwmom Mar 2014 #244

Ah yes ProSense Mar 2014 #8

Pres. Obama had everything to do with inviting Billy Tauzin and other lobbyists... polichick Mar 2014 #15

Obamacare ProSense Mar 2014 #19

Oh, this makes it cool that industry lobbyists wrote the bill... polichick Mar 2014 #24

No, what "makes it cool" ProSense Mar 2014 #26

I'm sick of all the bullshit. Dem Party leaders serve corporations and the 1%... polichick Mar 2014 #30

The people who are being help and whose lives are being saved ProSense Mar 2014 #33

Oh good grief - corporations benefit most from Obamacare, not people... polichick Mar 2014 #41

BS. n/t ProSense Mar 2014 #48

Thanks for finally stopping the commercial! polichick Mar 2014 #49

Debunking nonsense: ProSense Mar 2014 #52

More commercials - yes, we know, that's the job you've taken on. polichick Mar 2014 #55

You type fact-free rants. ProSense provides carefully annotated evidence. ConservativeDemocrat Mar 2014 #84

ProSense posts one never-ending commercial for the administration... polichick Mar 2014 #90

+1 The Masked Shrike Mar 2014 #358

And they say conservatives don't have a sense of humor. Jakes Progress Mar 2014 #233

You are both right Veilex Mar 2014 #87

"ladies,ladies...you're both pretty" sufrommich Mar 2014 #100

two things: Veilex Mar 2014 #457

I think you would do yourself a favor if you changed your subject line to remove the sexism. nt stevenleser Mar 2014 #139

WTF? cyberswede Mar 2014 #169

Perhaps I should be... Veilex Mar 2014 #458

Thanks! I sppreciate your sensitivity. cyberswede Mar 2014 #459

No worries... Veilex Mar 2014 #461

Bad form. I also ask you to edit your subject line to remove that comment. bluesbassman Mar 2014 #201

Done and done. Veilex Mar 2014 #460

Well done. bluesbassman Mar 2014 #468

Are you fucking kidding me? cui bono Mar 2014 #303

Not sexism.... Veilex Mar 2014 #462

Thank you. cui bono Mar 2014 #467

No worries... Veilex Mar 2014 #470

There are million of people, 5 million in fact . . . brush Mar 2014 #237

Maybe we can run ads against Dems who refuse to support a public option... polichick Mar 2014 #250

So cynicism is going to get single payer passed? brush Mar 2014 #259

Do you think the establishment would nominate a presidential candidate... polichick Mar 2014 #265

Shaw would have said that about Obama in 2007 also brush Mar 2014 #275

Or maybe it's all of us who voted for "hope and change" who... polichick Mar 2014 #281

I like Bernie quite a bit. Don't know if he has a better chance than Warren though brush Mar 2014 #304

Thank you, ProSense. Wait Wut Mar 2014 #98

What I am getting is certainly NOT crumbs... VanillaRhapsody Mar 2014 #163

In an obscenely wealthy democracy, if you're not getting first-rate universal healthcare... polichick Mar 2014 #235

The ACA will save my neice's life. She must be a corporation or in the 1%. JoePhilly Mar 2014 #287

You need to learn to read more carefully... polichick Mar 2014 #292

Clearly we need to repeal the ACA ... it only helps the 1% and corporations. JoePhilly Mar 2014 #301

If you say so. polichick Mar 2014 #305

Can you check your speed dial ... I'll need Boehner's #. JoePhilly Mar 2014 #307

Do you do anything to change things other than post on DU ? lumpy Mar 2014 #323

Ignoring feedback from people that are not being helped or who are being economically hurt Lars39 Mar 2014 #32

Wait, ProSense Mar 2014 #40

The beef people have is with how it all came about....Obama taking single payer off the table Lars39 Mar 2014 #57

Obamacare has nothing to do with how formularies "came about." Nothing. ProSense Mar 2014 #62

The problems run deeper than formularies Lars39 Mar 2014 #86

These threads are about formularies. n/t ProSense Mar 2014 #99

In part, but your responses seem to be the same no matter what problem is identified Lars39 Mar 2014 #111

But after he owned the program he owns it. Not just the good parts but the bad as well. nt Mojorabbit Mar 2014 #113

It's not a part of the law. It's not. n/t ProSense Mar 2014 #122

It is his signature program. He does not get to only own the good parts. nt Mojorabbit Mar 2014 #142

That's when Obama lost my vote brooklynboy49 Mar 2014 #78

Uhuh Bobbie Jo Mar 2014 #205

You do know he's not running for president again, right? How could he lose your vote? uppityperson Mar 2014 #230

I am well aware of the provisions of Amendment XXII brooklynboy49 Mar 2014 #337

You did not even vote for local people or issues? wow. uppityperson Mar 2014 #340

So who did you vote for? brush Mar 2014 #241

I did the unthinkable brooklynboy49 Mar 2014 #332

At least you didn't do the really unthinkable by voting for Romney brush Mar 2014 #351

Apparently it wasn't too unthinkable... one_voice Mar 2014 #354

Actually, it was brooklynboy49 Mar 2014 #381

and that was then this is now... VanillaRhapsody Mar 2014 #167

Problems must be identified in order to be addressed properly and solved. Lars39 Mar 2014 #172

that wasn't addressed at a problem...that was addressed to a dead horse.... VanillaRhapsody Mar 2014 #176

And it can be done, but not if the people and their problems with ACA are ignored. Lars39 Mar 2014 #183

THAT wasn't the "dead horse" now was it? VanillaRhapsody Mar 2014 #185

People have moved on, but they want ACA problems solved. Lars39 Mar 2014 #204

so will's family did what they were supposed to do questionseverything Mar 2014 #314

The cost and the formulary are two different things theboss Mar 2014 #320

saying the cost and formulary are two different things is dishonest questionseverything Mar 2014 #330

HMOs use formularies. Britain and Canada's health care systems use formularies.They are an effective Hekate Mar 2014 #448

Drug formularies in Canada and Great Britain naturallyselected Mar 2014 #29

Too many on here don't want to hear that. I agree it "should not happen," just like people Hoyt Mar 2014 #116

It will if legislated to do so in my opinion. nt Mojorabbit Mar 2014 #118

THANK YOU. I wish we could highlight your post in RED. Hekate Mar 2014 #428

ProSense... I Don't Think I've Ever Agreed With You On ANYTHING.... ChiciB1 Mar 2014 #380

Your anger is understandable. CJCRANE Mar 2014 #9

+1 one_voice Mar 2014 #12

you nailed it steve2470 Mar 2014 #21

Medicare for All was realistic in 2009, but no one fought for it. Scuba Mar 2014 #34

I guess we agree to disagree on that point steve2470 Mar 2014 #45

Medicare Part D uses formularies. n/t ProSense Mar 2014 #46

Photosynthesis uses light. n/t Scuba Mar 2014 #63

Facts are facts. n/t ProSense Mar 2014 #68

Bananas are bananas. n/t Scuba Mar 2014 #73

and sometimes a cigar is just a cigar... VanillaRhapsody Mar 2014 #173

Indeed, Medicare Part D does use formularies. blue neen Mar 2014 #318

Your post is a level-headed one. How refreshing. Thanks, keep it up. lumpy Mar 2014 #328

Thank you. blue neen Mar 2014 #339

Will, if Mrs. Pitt were on Medicare, would her drugs in question be covered or not? Nay Mar 2014 #387

You're forgetting about the blue dog dems — repug lites . . . brush Mar 2014 #254

Medicare limits drugs through its own formulary. So how do you know pnwmom Mar 2014 #372

Medicare for all wouldn't necessarily solve this problem. Medicare has a formularly, too. n/t pnwmom Mar 2014 #371

If Bush had passed the ACA, DU would have melted down n/t leftstreet Mar 2014 #11

Did Bush ever suggest anything like that? CJCRANE Mar 2014 #14

Medicare part D? (nt) Nye Bevan Mar 2014 #27

As much as I hate g war bush, he did sign Medicare prescription drug plan. Before that poor elderly, Hoyt Mar 2014 #127

agreed Puzzledtraveller Mar 2014 #162

That's like saying if Bush supported marriage equality or became pro-choice... Drunken Irishman Mar 2014 #247

+1 uponit7771 Mar 2014 #435

Yea, I would've melted down with joy that Bush did something that actually saved lives. phleshdef Mar 2014 #311

YOU SHOULD HAVE BEEN A SMARTER CONSUMER, YOU PATHETIC LOSER! Zorra Mar 2014 #13

please please please vote in the midterms oldandhappy Mar 2014 #16

Interestingly, Will very recently had a post saying exactly that. MH1 Mar 2014 #66

"Obama not wringing a better health care plan...Congress" - HE'S the one who packed... polichick Mar 2014 #106

AND he is the FIRST President to get changes to Healthcare in America... VanillaRhapsody Mar 2014 #184

Yes he managed to mandate that everyone pay insurance companies... polichick Mar 2014 #236

Yes and expanding Medicaid for the poor was such a horrible tragedy! VanillaRhapsody Mar 2014 #240

That's what you get -- Hell Hath No Fury Mar 2014 #17

+1 area51 Mar 2014 #179

M-O-N-E-Y TorchTheWitch Mar 2014 #312

Well, you had two options. jeff47 Mar 2014 #20

Anger is important - it's way past time Americans got angry... polichick Mar 2014 #36

Blind rage never solved any problems. jeff47 Mar 2014 #44

It's hardly "blind" - it's CLEAR-EYED, WIDE AWAKE rage, the kind this country needs... polichick Mar 2014 #47

If it was, it would be directed at the people who actually prevented single-payer. jeff47 Mar 2014 #59

Wake up - the guy in the WH invited Billy Tauzin and other lobbyists in... polichick Mar 2014 #69

Waking up would require realizing single-payer doesn't fix this problem. jeff47 Mar 2014 #333

My post was about the lobbyists who were constant guests at the WH... polichick Mar 2014 #338

I did by pointing out the WH doesn't pass legislation. jeff47 Mar 2014 #343

Activists on the left ran ads targeting Blue Dog Dems... polichick Mar 2014 #345

Ads don't help when he's not running again. jeff47 Mar 2014 #348

Others were running. The point is we have to be clear about... polichick Mar 2014 #352

Others don't matter. You need Lieberman's vote. jeff47 Mar 2014 #356

Joe didn't even matter, since the WH traded that away... polichick Mar 2014 #359

Yes, Joe does matter when you claim that Obama could have single-payer. jeff47 Mar 2014 #361

You do know that the WH nixed single payer and the public option... polichick Mar 2014 #363

We should still have single-payer. Doesn't mean Will's wife gets her drugs. theboss Mar 2014 #347

imo it's amazing that Americans accept this situation... polichick Mar 2014 #349

President Obama was elected with a mandate and he failed*to lead on the important issues. That buck xocet Mar 2014 #128

Because bills magically appear on his desk. There is no other branch involved. jeff47 Mar 2014 #334

Nothing ventured: nothing gained. He did not even try. You can figure the rest out yourself. n/t xocet Mar 2014 #365

This is true - he "threw away" support with both hands... polichick Mar 2014 #353

Thanks for the specifics and the note about the status quo. n/t xocet Mar 2014 #415

Not blind rage to call the Democratic President a "piece of shit"? VanillaRhapsody Mar 2014 #189

anger is not important when it blinds you to possible solutions Whisp Mar 2014 #245

imo the calm acceptance of The Screwing of America... polichick Mar 2014 #253

the Grand Screwing sure didn't start with Obama Whisp Mar 2014 #267

No, it didn't start with him - but he's cool with enabling the continuation... polichick Mar 2014 #278

Obama has done an amazing amount of good work Whisp Mar 2014 #308

Well, I've never said he's an "evil piece of shit"... polichick Mar 2014 #309

All my book says is: Whisp Mar 2014 #315

Does Pres. Obama WANT to turn the Titanic? If so, why the TPP? polichick Mar 2014 #321

poor deflection, but expected. n/t Whisp Mar 2014 #324

Not a deflection at all. If he wants to "turn the Titanic"... polichick Mar 2014 #329

I think you miss the point Whisp Mar 2014 #355

It's not too much to expect a Democratic president to invite... polichick Mar 2014 #357

Thank you for your posts in this thread dreamnightwind Mar 2014 #439

My pleasure! imo the most interesting thing happening right now is... polichick Mar 2014 #455

Yes to Bernie dreamnightwind Mar 2014 #484

And now there's this: polichick Mar 2014 #487

Great! dreamnightwind Mar 2014 #491

Yeah, the more the merrier. I too thought about how close he has been... polichick Mar 2014 #494

What action are you involved in other than being angry and posting on DU. lumpy Mar 2014 #331

This message was self-deleted by its author CJCRANE Mar 2014 #82

This mcar Mar 2014 #214

If a policy (or law) can't stand criticism, it should be concidered a weak policy. canoeist52 Mar 2014 #22

"betrayal can be a cruel mistress at the poles." zeemike Mar 2014 #56

calling the President a "piece of shit" is just "criticism" of the ACA? VanillaRhapsody Mar 2014 #192

Is that the full quote, or just part of it? truebrit71 Mar 2014 #206

Did he say it or didn't he? VanillaRhapsody Mar 2014 #211

What is the FULL QUOTE? truebrit71 Mar 2014 #216

He said "piece of shit".....let us not forget the "fuck you" part then either... VanillaRhapsody Mar 2014 #218

Nice try... truebrit71 Mar 2014 #223

No it isn't when it is bullshit....which it is...NO healthcare system in the world covers VanillaRhapsody Mar 2014 #224

Except it isn't bullshit... truebrit71 Mar 2014 #269

Except that it is....NO healthcare system covers ALL drugs and treatments in any country... VanillaRhapsody Mar 2014 #272

Did you miss the part where the drugs WERE covered before... truebrit71 Mar 2014 #277

and that happens all the time in EVERY system....did you not read that? VanillaRhapsody Mar 2014 #282

So that is not bullshit in your opinion? truebrit71 Mar 2014 #284

No its NOT bullshit when MOST did keep their insurance....sorry...you fail. VanillaRhapsody Mar 2014 #288

Aaah...."most"..... truebrit71 Mar 2014 #300

May I explain what a pre-existing condition exclusion is? theboss Mar 2014 #294

Hence his (IMHO) justifiable outrage... truebrit71 Mar 2014 #299

They were NOT covered before theboss Mar 2014 #286

So that's actually a "yes, she was covered before" then... truebrit71 Mar 2014 #296

She switched plans because she quit her job theboss Mar 2014 #302

This message was self-deleted by its author Autumn Mar 2014 #298

I'm pissed too ... Auggie Mar 2014 #23

This is not reduced pharmaceutical coverage. Ms. Toad Mar 2014 #251

+1000 sinkingfeeling Mar 2014 #445

Did you vote for Obama? Then it's your fault, not his. Voice for Peace Mar 2014 #25

Not voting for Obama DonCoquixote Mar 2014 #252

It's the blame thing. It is 100% ineffective, and in my opinion Voice for Peace Mar 2014 #310

it would only be misinformation DonCoquixote Mar 2014 #336

you are off on a wholly other track. Voice for Peace Mar 2014 #344

The "misinformation" refers to people getting the wrong idea about Voice for Peace Mar 2014 #346

I see 2 large tasks ahead of you... magical thyme Mar 2014 #28

I second what MT said BuelahWitch Mar 2014 #368

Of course he is part of it - TBF Mar 2014 #31

Message auto-removed Name removed Mar 2014 #35

These pretzels are making me thirsty. nt sufrommich Mar 2014 #38

Stay classy... truebrit71 Mar 2014 #39

Message auto-removed Name removed Mar 2014 #51

You sound exactly like someone who would say the same thing to struggling poor people Vashta Nerada Mar 2014 #54

~sprays troll-be-gone~ Marrah_G Mar 2014 #61

Oh happy day! Puglover Mar 2014 #146

So this isn't one of those Will Pitt rants that is retracted in two days? theboss Mar 2014 #37

Heavens, no.... Hekate Mar 2014 #449

Well, for one, there haven't been any verified Obamacare horror stories that I've found. DanTex Mar 2014 #42

Hmmm, problem solved ... 1StrongBlackMan Mar 2014 #126

Your anger was justified and the vile attacks against you were not. Vashta Nerada Mar 2014 #50

No in fact it wasn't.... VanillaRhapsody Mar 2014 #196

Heck, up until 2005, Medicare did not cover any prescription drugs, absolutely none unless injected. Hoyt Mar 2014 #213

Exactly! Sheesh you just cannot please some people... VanillaRhapsody Mar 2014 #215

His wife is suffering needlessly, and he isn't justified in being angry about it? nomorenomore08 Mar 2014 #492

Pitt, with all due respect and zero snark.... steve2470 Mar 2014 #53

I did. WilliamPitt Mar 2014 #64

best of luck to you nt steve2470 Mar 2014 #67

I actually do this for a living theboss Mar 2014 #71

OK WilliamPitt Mar 2014 #80

Good God...Find out the answer to #2, like, today theboss Mar 2014 #89

The only other options WilliamPitt Mar 2014 #97

Okay...so there are options theboss Mar 2014 #105

No. WilliamPitt Mar 2014 #107

When did she lose her old coverage? Was COBRA an option? theboss Mar 2014 #114

Excellent insurance provided by her employer WilliamPitt Mar 2014 #130

Dates please theboss Mar 2014 #137

This has been a very good exchange of posts. Hope it continues. Hoyt Mar 2014 #141

Moved in August WilliamPitt Mar 2014 #158

It's way too late now, but staying on COBRA until you had a answer - or the enrollment period ended theboss Mar 2014 #171

I do. WilliamPitt Mar 2014 #177

You're not insane theboss Mar 2014 #190

This is excellent advice. Having a disabled child on two non-formulary medications, I can msanthrope Mar 2014 #202

I should have just yelled about Obama theboss Mar 2014 #210

Fuck writing appeal letters!! Fuck getting a letter from the doctor!!! Fuck working your msanthrope Mar 2014 #231

It's a web forum. WilliamPitt Mar 2014 #243

You didn't vent; you mischaracterized your problem theboss Mar 2014 #256

Thank You, theboss! Cha Mar 2014 #392

Keep fighting. AtheistCrusader Mar 2014 #129

once weekly injections are not bad at all blindersoff Mar 2014 #161

So ... 1StrongBlackMan Mar 2014 #180

It's MS. WilliamPitt Mar 2014 #182

In fairness, you have stated that there are other treatment options covered theboss Mar 2014 #194

That is my exact point ... 1StrongBlackMan Mar 2014 #228

No ... 1StrongBlackMan Mar 2014 #234

there may be a good reason for "of my choice" shireen Mar 2014 #376

no it's most likely not a life or death situation blindersoff Mar 2014 #238

My mother died of MS and insurance companies suck. uppityperson Mar 2014 #242

Wow, not a bit of compassion BuelahWitch Mar 2014 #366

Maybe ... 1StrongBlackMan Mar 2014 #370

Phone calls aren't the same as an appeal. Ms. Toad Mar 2014 #261

TheBoss, you are patient and knowledgable, and this subthread is invaluable... Hekate Mar 2014 #450

Yea....I'm awesome theboss Mar 2014 #456

good to hear blindersoff Mar 2014 #138

Do you believe Medicare just magically covers every drug and every treatment? VanillaRhapsody Mar 2014 #198

Nope steve2470 Mar 2014 #200

Obama's goal and accomplishment were the MANDATES and the SUBSIDIES.... Demo_Chris Mar 2014 #58

+1 leftstreet Mar 2014 #72

TRUE. That's the hope and change we elected... polichick Mar 2014 #75

I get less enthused as each election cycle passes... truebrit71 Mar 2014 #83

What a con game, huh? polichick Mar 2014 #103

+2 truebrit71 Mar 2014 #77

Of course, but then it wouldn't have had a chance in hell of passing elias7 Mar 2014 #133

But that was the whole problem... truebrit71 Mar 2014 #143

Yeah, ask Hillary Clinton about how her health care proposal went. Hoyt Mar 2014 #226

And as someone that grew up with a National Health System I still can't figure out... truebrit71 Mar 2014 #229

^^^^^^^This is the correct answer.^^^^^^ woo me with science Mar 2014 #92

Indeed! truebrit71 Mar 2014 #159

Absolute ProSense Mar 2014 #104

Actually, you are not required by law to purchase their product . . . markpkessinger Mar 2014 #440

Have you looked at the programmed penalty increases... Demo_Chris Mar 2014 #451

Obama bashing never ceases. lumpy Mar 2014 #480

Well, he might have angered liberals, but his corporate buddies still love him. nt Demo_Chris Mar 2014 #489

it's the Insurance Industry Protection Act.... mike_c Mar 2014 #60

You know what? WilliamPitt Mar 2014 #70

It's a mixed bag, and people are learning theboss Mar 2014 #76

Interesting perspective. TBF Mar 2014 #88

Some doctors like it; some don't theboss Mar 2014 #101

Agree on the ERs for sure - TBF Mar 2014 #276

here in rural NorCal they're throttling the providers too.... mike_c Mar 2014 #91

I think they love this bill BECAUSE it allows them to protect their profits Auggie Mar 2014 #123

I think you are correct Will sweetapogee Mar 2014 #151

Health Insurance Company bailouts/guaranteed profits are nationalize the fed Mar 2014 #175

This should be an OP. woo me with science Mar 2014 #378

you got that right Puzzledtraveller Mar 2014 #165

Why are you immune to DU rules? nt ChisolmTrailDem Mar 2014 #65

what du rule? leftyohiolib Mar 2014 #81

Code of Conduct or whatever you want to call it. Are you defending the OP? nt ChisolmTrailDem Mar 2014 #85

i justwanted to know what rule he's violating a coc violation? leftyohiolib Mar 2014 #93

I'm not playing your game with you. You know what the OP said. It's telling that he ChisolmTrailDem Mar 2014 #96

what game is that? idk what youre talking about i just wondered what rule he violated leftyohiolib Mar 2014 #102

My apologies. I'm pretty sure it's against DU CoC and/or rules to call our president ChisolmTrailDem Mar 2014 #121

there are privileges that that poster has that no one else ever had Whisp Mar 2014 #155

Twice? I knew about the bobbolink dustup...what was the other one??? nt msanthrope Mar 2014 #360

I am PMing you. Whisp Mar 2014 #375

And someone else wrote "Fuck You Bill Pitt' in that same thread and that was allowed to stand... truebrit71 Mar 2014 #181

Again, I am not outraged. Your reading comprehension needs work. As I said, I am merely curious ChisolmTrailDem Mar 2014 #193

no i was just curious since i didnt see any obvious rule broken. iwasnt trying to join in any leftyohiolib Mar 2014 #317

Three words Will. Insurance Finance Reform. Autumn Mar 2014 #74

"Given the heated and often misleading rhetoric surrounding this legislation " ProSense Mar 2014 #95

You skipped the Insurance finance Reform part. Autumn Mar 2014 #110

Yes, and ProSense Mar 2014 #117

Insurance Finance Reform. Autumn Mar 2014 #136

Keep raising hell, Will! Nothing's ever going to change in this country LuvNewcastle Mar 2014 #79

Even under single-payer, this would be a problem theboss Mar 2014 #109

I don't think the law is perfect, but it is better than what we had. LexVegas Mar 2014 #108

This is not a monarchy. nt Sarah Ibarruri Mar 2014 #112

I'm curious if this particular drug was covered by Anthem Purrfessor Mar 2014 #115

Really good question........ theboss Mar 2014 #124

That question was asked several time yesterday of the OP. He seems to be bluestate10 Mar 2014 #394

Because ... 1StrongBlackMan Mar 2014 #147

We need Single Payer. The President can't sign a bill Congress doesn't hand him. AtheistCrusader Mar 2014 #119

Single payer would have this same problem theboss Mar 2014 #125

There are always changes, agreed. AtheistCrusader Mar 2014 #134

Ok....here is where the frustrated healthcare veteran in me comes out. Please give me a second. theboss Mar 2014 #156

I can take it. AtheistCrusader Mar 2014 #164

I feel you. bravenak Mar 2014 #219

May I just say that it seems odd that you are angry at Will Pitt for Autumn Mar 2014 #369

My fellow DUers are going to Maui with electrode salesmen? theboss Mar 2014 #453

From the back and forth with AtheistCrusader it seemed it was Autumn Mar 2014 #454

Sounds like healthcare works like Congress. nt valerief Mar 2014 #463

This is why you need to call the insurance commissioner nadinbrzezinski Mar 2014 #120

I'm not sure what Anthem did wrong to be honest theboss Mar 2014 #131

Here is the problem in a nutshell nadinbrzezinski Mar 2014 #140

Every medicine approved by the FDA? theboss Mar 2014 #144

And this is where we should be talking single payor. nadinbrzezinski Mar 2014 #154

How would Single Payer solve the alleged problem? nt. bluestate10 Mar 2014 #395

The fedfs negotiate one single formulary nadinbrzezinski Mar 2014 #396

Wow. WilliamPitt Mar 2014 #152

That's a damn good argument against them theboss Mar 2014 #160

The very argument I made to them today WilliamPitt Mar 2014 #168

Dan can't do anything theboss Mar 2014 #195

Will, it's time to start writing letters of appeal, and getting your wife a clinician at the msanthrope Mar 2014 #207

In the meantime it might be worth contacting the pharma that makes the med mcar Mar 2014 #232

This was probably the best advice on the whole thread theboss Mar 2014 #471

Hey There "Nadinbrzezinski" You Are One Here That I Know ChiciB1 Mar 2014 #374

You should also contact the insurance commissioner nadinbrzezinski Mar 2014 #377

What Delegation? AND I Think This IS A Formulary ChiciB1 Mar 2014 #388

Your congress critter nadinbrzezinski Mar 2014 #390

Okay... ChiciB1 Mar 2014 #398

I live on the other coast nadinbrzezinski Mar 2014 #400

Well At Least You Do Have Some ChiciB1 Mar 2014 #401

I mentioned Hunter since he represents a red blood district nadinbrzezinski Mar 2014 #402

Could Be True... ChiciB1 Mar 2014 #409

It is worth trying nadinbrzezinski Mar 2014 #411

Me Either! ChiciB1 Mar 2014 #413

When did medical insurance start being called healthcare? valerief Mar 2014 #132

When uninsured folks started to hear "go elsewhere or pay cash," when calling for an appointment. Hoyt Mar 2014 #150

And when did 'mandate' start being called 'universal?' leftstreet Mar 2014 #153

k&r, again Puzzledtraveller Mar 2014 #135

How does the government ohheckyeah Mar 2014 #255

Exactly Puzzledtraveller Mar 2014 #257

That's it.... ohheckyeah Mar 2014 #273

Quit while you are only this far behind. n/t Whisp Mar 2014 #145

K&R woo me with science Mar 2014 #149

There was a reason why people thought this would lead to nationalized health care Yo_Mama Mar 2014 #166

you are going to hear the same kooky and crackpot defense of the ACA that you hear for the NSA from Douglas Carpenter Mar 2014 #170

It actually doesn't look to be ACA related at all.... msanthrope Mar 2014 #187

the ACA allows it. That didn't have to be Douglas Carpenter Mar 2014 #208

No one said you can get every drug you want theboss Mar 2014 #217

no, but it implied you can get the ones you need. Douglas Carpenter Mar 2014 #222

And if you read the full thread, Will's wife can get MS drugs theboss Mar 2014 #225

Formularies exist in single-payer, too. Of course you have formularies. msanthrope Mar 2014 #227

The ACA will save my neice's life. She's not part of the NSA. JoePhilly Mar 2014 #291

The simple fact is that this would have happened if the ACA had never geek tragedy Mar 2014 #386

Will, please correct the incorrect insurance information in your other thread--- msanthrope Mar 2014 #178

Don't interrupt ProSense Mar 2014 #188

Forget it, he's rolling.... msanthrope Mar 2014 #197

The Truth just woke up and is putting on it's running shoes. Wonder whether bluestate10 Mar 2014 #397

That family friend sounds like a Ron Pauler or a Bagger Whisp Mar 2014 #199

Our grand experiment in Free Market National health care is not succeding Agnosticsherbet Mar 2014 #186

This message was self-deleted by its author KamaAina Mar 2014 #203

My prayers for your wife but it still doesn't justify calling the President a "piece of shit" brush Mar 2014 #209

What was the full quote? truebrit71 Mar 2014 #212

Your blame is misplaced. A formulary is not some invention of the ACA or even of private insurers. pnwmom Mar 2014 #239

This isn't a one size fits all kind of thing, is it? LiberalAndProud Mar 2014 #248

I AM grateful that I can get far enough to have to jump through hoops for meds, Will. ScreamingMeemie Mar 2014 #249

Being angry at public servants that we pay is not PC..if they're Democrats. Tierra_y_Libertad Mar 2014 #263

Apparently so... truebrit71 Mar 2014 #271

I will mock your anger in no way. NCTraveler Mar 2014 #266

My 2 cents: Approx. 1 in 5 folks have a hole in their hearts--most don't know it. hue Mar 2014 #274

He'll also get credit for saving my neice's life. JoePhilly Mar 2014 #306

Will Pitt I understand how you feel riverbendviewgal Mar 2014 #316

Can you get any drug you want? theboss Mar 2014 #319

I dont know what those are. riverbendviewgal Mar 2014 #325

Here: ProSense Mar 2014 #326

Thanks ProSense riverbendviewgal Mar 2014 #327

Medical systems in civilized countries have formularies nadinbrzezinski Mar 2014 #364

Will, this fight isn't over and hasn't been ever. Skidmore Mar 2014 #341

Your wife's situation should not be happening to anyone in the United States, to say Obama's Jefferson23 Mar 2014 #342

When you're right, you're right. I'm sorry for your perdicament, Will. badtoworse Mar 2014 #350

may I say, William Skittles Mar 2014 #367

You don't have it straight. gulliver Mar 2014 #379

That isn't the point. ProSense Mar 2014 #389

I will put forward the real possibility that the OP's plan offers alternatives, bluestate10 Mar 2014 #399

Shhhh.. not suppose to mention the OP doesn't have shit straight or being straight. TYG. Cha Mar 2014 #422

So, basically the ACA is junk insurance. KatyaR Mar 2014 #385

Dude, just move across the border and get insured in Massachusetts. nt. bluestate10 Mar 2014 #391

I was once denied coverage for my son's broken arm... Junkdrawer Mar 2014 #393

It is too bad all that forward momentum to fix our health care mess was basically wasted. raouldukelives Mar 2014 #403

+1 840high Mar 2014 #408

+1 JVS Mar 2014 #417

sadly, so many people are falling for it Skittles Mar 2014 #438

ObamaCare, it's the best legislation rightwing Heritage Foundation could write. blkmusclmachine Mar 2014 #407

ACA allows insurance companies to charge "lifesytle" premiums pragmatic_dem Mar 2014 #410

Kucinich had a better plan. Medicare for all. Spitfire of ATJ Mar 2014 #412

Yeah, too bad not enough votes. He did Vote for ACA.. along with Alan Grayson and Cha Mar 2014 #420

It has always been called "a first step".... Spitfire of ATJ Mar 2014 #423

The gop have tried to REPEAL it 50.. they sure don't want it to go Cha Mar 2014 #424

Well sure. Their message doesn't fly when every other country has it but us.... Spitfire of ATJ Mar 2014 #426

LOL! Cha Mar 2014 #430

For the record... NYC_SKP Mar 2014 #434

...and under it, Will would most-likely still be getting initially rejected. Chan790 Mar 2014 #437

She would probably still not be able to get these meds under Medicare for all theboss Mar 2014 #444

USA, The Big Money The Wizard Mar 2014 #414

I know you are justifiably angry, but there is recourse KauaiK Mar 2014 #418

Now, now now..... DeSwiss Mar 2014 #419

No, you don't have it "straight". jazzimov Mar 2014 #425

What you said. It's been a long 13 years for all of us. Hekate Mar 2014 #432

This is the reason (along with not being able to afford it) that I won't get coverage.......... mrmpa Mar 2014 #427

I'm so very glad I got my children raptor_rider Mar 2014 #429

An important post, Will. madfloridian Mar 2014 #431

And.... Coyote_Bandit Mar 2014 #443

Here's the 'Specialty Drug' list from Anthem BC - New Hampshire for MS: sinkingfeeling Mar 2014 #446

someone's parsing words . . . mzteris Mar 2014 #452

And it largely depends on where you live. alarimer Mar 2014 #486

Well OwnedByCats Mar 2014 #488

Appeals work-In 1993 or so, Blue Cross denied a sleep study for me Gothmog Mar 2014 #490

As usual, people would rather whine about their supposed hurt feelings than focus on what actually nomorenomore08 Mar 2014 #493