Hello, I am hoping someone can provide insurance advice. In 2016, I was diagnosed with WBC disorder (D72.9), Polyclonal hypergammaglobulinemia (D89.0), and
coagulation disorder Hereditary Thrombophilia (D68.59). My doctor applied for IVIG in January 2018, and Aetna approved the request. In July 2018, I was up for reauthorization. Aetna initially denied the request, stating that I did not meet the plan’s guideline criteria due to the diagnosis (the same diagnosis as in January 2018). However, after a written appeal from my doctor, they approved the IVIG the same day. Fast forward to January 2019 when my reauthorization was up again. Aetna denied the request as well as the appeal, again stating that I did not meet the plan’s guideline criteria due to the diagnosis (the same diagnosis as before). I am now pregnant and want to do everything I can to calm my immune system in order to give this baby a fighting chance. Does anyone have any advice about next steps? I would appreciate any input. Thank you!
Thank you so much for your time and for the above information. I had previously read the CNN article about Aetna–it is simply infuriating!! I will check out the other links you provided as well. I really appreciate it!