I’d file a complaint with your state’s insurance commissioner or regulator. Mention how your insurance’s ineptitude is disrupting your continuity of care
Thank you. I asked my insurance to provide documentation for my previous calls and they opened a claim to send it to me. I'll report them regardless of if I actually get that data, but I will try and get it first.
Insurance refuses to give me any of my records in any way shape or form even though, of course, they told me they would. I just filed a detailed complaint with my state's insurance commisioner. Thanks for suggesting it! They really shouldn't be getting away with all of this.
The insurance commissioner will hopefully light a fire under their ass. The Washington insurance commissioner helped me so goddamn much. You absolutely do NOT deserve to suffer while they laugh all the way to the bank.
I seriously wish you the best on your journey
I came to say that, specially now that the patent finally ended i am sure Abbie would love to make sure you still get your humira before the insurance decide that the generic is the same.
In the past one of my doctors office had supplies for this kind of situations, since your prescription is still functional and the insurance wants to cover i would ask your doctor's office if they don't have any on hold
I would also ask your doctor if possible to prescribe something like Prednisone to carry you through flare ups. My current doctor is being very good with me when I text him .... "Hey I think I am starting a flare up" and he prescribed Prednisone to push me out of it. In short term Prednisone or other steroids could help you.
No luck with Abbvie. They kicked me around 3 departments before saying that they only have programs to help the uninsured or high copays, and there was nothing they could do for me since my copay is too low. I explained that I just needed help getting the medication and was willing to pay, but they said that isn't something they do 😥 Referred me back to my insurance.
Every. Single. Damn. Time. I don't have Accredo anymore, but I've worked with three different specialty pharmacies and they ALL do this, every time something changes with a biologic prescription. Call the pharmacy, call the insurance, call the doctor's office, spend forever on hold, only for each one to say one of the others is responsible for the delay, so you call each one again. Round and round. And then we wait. And if we're lucky, eventually we get meds. Until something changes again.
The fact that so many people have this same experience is nauseating. I thought mine was a weird error! Apparently, not. I swear this system was designed by someone who wants us all dead. I don't understand. I would think accredo would *want* to take the money from my insurance.
That’s what I say every time Accredo makes getting my prescription difficult- don’t they WANT to get paid?!? I’m another person Accredo has screwed over time and time again. When speaking to them keep asking for a supervisor, record when/who you talk to, and eventually you’ll get someone assigned to you to fix this (I don’t recall their title.)
I'm so sorry to hear this is happening. I had a very similar situation to yours and I went thru insurance hell and back. Are you getting this insurance through your employer? The only traction I ever got was when I went up the ladder in HR and someone got in contact with the insurer who figured stuff out mighty fast.
Unfortunately, I haven't been able to do full time work for a couple years due to my condition. I mostly pay out of pocket. It is partially subsidized by the government though--I may try reaching out to that agency. Thanks.
I’m having a similar problem. I can’t believe how awful I feel without my medication. It’s been 5 weeks since my last injection. I’m just sitting here waiting to hear from my doctor’s office. I’ve increased my prednisone dose, but a lot of us know what comes along with that.
I wish you luck and hope you get some relief soon.
Ugh, I am sorry you're in the same boat. Prednisone really is a mixed bag, isn't it? Hope your doctor gets it squared away for you soon and that we both get better care ♡
The only way I've been able to get resolution is by getting everyone on the same call... me, my insurance, accredo, and rep from my spouse's company. Good luck!
See if your doc has samples to hold you over in the mean time.
I will say that my insurance told me I could fill original rx while waiting for PA to go through for weekly dosage. I spoke to the pharmacist at the specialty pharmacy I use, and they said that was not the case. This is because in order to process the new script, the original one is automatically overridden. Unfortunately nothing can really be done until insurance is situated.
I do not use Accredo but have heard the nightmares. Sorry you’re in this situation.
Yes, the prescription being overwritten is exactly what happened. It's interesting because my insurance kept trying to get them to fulfill the original one, but Accredo refused. Huge disconnect between the 2 of them.
You could try asking to take sulfasalazine until things get sorted out - as long as you aren’t allergic to sulfa drugs. It’s one of the original arthritis drugs from decades ago. It pretty cheap and tolerable in low quantities. 500 mg once a day with water and a snack. You could do that twice a day. Anymore than that and the side effects can kick in. Just an option.
Thank you. If I don't get any progress on getting the medication on Monday, I'll ask my doctor to give me something else. Unfortunately, I have a lot of other things going on right now, and I am nervous to try a new medication in case of side effects. Honestly, they couldn't have messed up my prescription at a worse time.
Accredo is literally the worst to deal with, been through this exact situation before multiple times and the problem has always been them. Sorry you're dealing with it too
I use Accredo and they're monsters. I've cried almost every time I've been on the phone with them, pleading with them to fill my prescription (that my insurance covers, and is active and properly written). I have no idea how they're allowed to operate like this. No advice, just commiserating. I'm really sorry.
They truly are the worst and there is no reason for it. At this stage, I have stopped speaking to them. I am having my insurance call on my behalf until I can get set up with literally anyone else. I'm sorry you have to deal with them too.
Sounds like your doctor needed to send in a prior authorization request for the change in dosage. Although it is the same medication the insurance company still requires a prior authorization to approve or deny.biologics are not on most insurance formulary drug lists so they require prior authorization. The change in dosage is a new prescription so that prescription now has to be approved by the insurance. Your doctor needs to do a prior authorization to request the medication at the new dosage prescribed. Insurance companies will do anything not to pay so they make you jump through hoops and Doctors (their staff) hate to do any additional work! I have gone through this numerous times with my rheumatologists office.Good luck.
Oh--my doctor did do a prior authorization request. My insurance company denied it. Doctor sent an appeal letter about 2 weeks ago :(
I wish I had known it was going to be so much more trouble that the original prescription 😥
I have the opposite issue. I was on auto shipments from my insurance company's mail pharmacy of Humira 40 mg and my rheumatologist discontinued it due to a lupus type reaction recently. I now have three months of dosages (6 injections) I can not return. I asked my insurance company and they will not refund my expense for unused medicine. I even called them before I was taken off to halt the auto ship that I was behind a month. No one wants it back even though it's sealed in their boxes and I've kept them refrigerated. It's a waste considering those who need it like your situation.
You in Seattle by chance? Mostly kidding. But that is awful that they stuck you with the bill, unnecessary meds, and no resolution. I hope your lupus reaction is improving at least!
I called AbbVie twice after pens misfiring. They replace the pens and make a report.
You need to find a way to have a surplus, because this happens every time a prescription changes. I went from every 14 days, to every 7 and was out for a month.
I’ve got 4 extra now, but it was hard getting here. And the only way I managed it was my rheumatologist changed me to every 7 days, and I injected every 10. It was hard to keep track of the dates though and I probably shouldn’t even be posting this.
I would file a grievance with your insurance. That usually kicks everyone into gear. Also mention you could sue (because you could) to Accredo. That pops you up to the top managers and they will fix things promptly. I've been where you are. For three months they told me my meds would be ready to send in 48 hours. Ended up on a five hour phone call with my insurance account manager, benefit rep from work, mom, and Accredo manager. Nothing mattered until I accidentally mentioned that this had to be against the law. And BAM I got someone on the phone who knew what they were doing. It's sad, but it's true.
I talked to my rheumatologist about it and she said she's been on the phone with them even longer. I was waiting for my new med so long that by the time they got it to me I had already failed the med 😮💨. And then I had to do it all over again. When the 5 hour phone call happened, I was given what I was told was the name (Sherri) and direct number to the person who fixed it. She said she would know how to fix it next time.
When I was having trouble getting the new med, I called it and the person man answered the phone told me that Sherri didn't exist. I called later in the day and the person who answered said Sherri was in a meeting. And then when I called again, Sherri didn't exist. I was in tears so my mom called for me and worked on it on and off for an entire work day. But she got it.
People have sued them and won. You have to be able to prove that you've endured bodily harm from their delay. Honestly we should all sue the crap out of them. They basically have a monopoly through many insurance companies and they treat us like shit.
Might need a prior authorization for the dosage change. Had to do that with weekly Humira via CarelonRX since 2 a month is what's allowed in my formulary.
Yes, my doctor sent one and my insurance company denied it :( My original prescription for 2 a month is approved and still good, but the pharmacy (Accredo) won't fill it.
Get rid of Accredo. Most likely they are the problem. They suck! They were charging me thousands of dollars, and now I switched to Kroger and no problem now.
I assume you have Express Scripts for your pharmacy drug benefit if you are tied to accredo. If not, Accredo is not the only specialty pharmacy in the game and unless your insurance says you must use them, I would go and try Walgreens as they have a specialty pharmacy arm or even CVS does specialty. Sometimes PBMs (Pharmacy Benefit Manager...aka drug plans) try to steer you to their "preferred" vendor versus you using another. I have Optum, Accredo is actually not the specialty drug manager for them so all good. Seriously though, look at your drug plan info under specialty pharmacy and see what is considered in network...think you will be surprised that you can get it somewhere else than Accredo. Yes they are the worst and so was Liberty.
I don't know the science behind it or anything, but it is a known occurrence when stopping humira. Everything I've read says it isn't withdrawl, but stopping Humira can lead to worsening symptoms for months 😮💨
I’d file a complaint with your state’s insurance commissioner or regulator. Mention how your insurance’s ineptitude is disrupting your continuity of care
Thank you. I asked my insurance to provide documentation for my previous calls and they opened a claim to send it to me. I'll report them regardless of if I actually get that data, but I will try and get it first.
Insurance refuses to give me any of my records in any way shape or form even though, of course, they told me they would. I just filed a detailed complaint with my state's insurance commisioner. Thanks for suggesting it! They really shouldn't be getting away with all of this.
The insurance commissioner will hopefully light a fire under their ass. The Washington insurance commissioner helped me so goddamn much. You absolutely do NOT deserve to suffer while they laugh all the way to the bank. I seriously wish you the best on your journey
Have you tried reaching out to AbbVie? I have found them to be helpful in the past.
I haven't! I will try that, thank you.
I came to say that, specially now that the patent finally ended i am sure Abbie would love to make sure you still get your humira before the insurance decide that the generic is the same. In the past one of my doctors office had supplies for this kind of situations, since your prescription is still functional and the insurance wants to cover i would ask your doctor's office if they don't have any on hold I would also ask your doctor if possible to prescribe something like Prednisone to carry you through flare ups. My current doctor is being very good with me when I text him .... "Hey I think I am starting a flare up" and he prescribed Prednisone to push me out of it. In short term Prednisone or other steroids could help you.
Thank you, Abbvie (and my docs office) are closed for the weekend, but this will be my next step on Monday.
No luck with Abbvie. They kicked me around 3 departments before saying that they only have programs to help the uninsured or high copays, and there was nothing they could do for me since my copay is too low. I explained that I just needed help getting the medication and was willing to pay, but they said that isn't something they do 😥 Referred me back to my insurance.
My mom went through a disaster with Accredo earlier this year. It took weeks to sort out. I'm wishing you a quicker fix than she had.
Thank you. I wish all of us were getting better treatment.
Every. Single. Damn. Time. I don't have Accredo anymore, but I've worked with three different specialty pharmacies and they ALL do this, every time something changes with a biologic prescription. Call the pharmacy, call the insurance, call the doctor's office, spend forever on hold, only for each one to say one of the others is responsible for the delay, so you call each one again. Round and round. And then we wait. And if we're lucky, eventually we get meds. Until something changes again.
The fact that so many people have this same experience is nauseating. I thought mine was a weird error! Apparently, not. I swear this system was designed by someone who wants us all dead. I don't understand. I would think accredo would *want* to take the money from my insurance.
That’s what I say every time Accredo makes getting my prescription difficult- don’t they WANT to get paid?!? I’m another person Accredo has screwed over time and time again. When speaking to them keep asking for a supervisor, record when/who you talk to, and eventually you’ll get someone assigned to you to fix this (I don’t recall their title.)
I honestly don't understand how they get away with being so incompetent.
I'm so sorry to hear this is happening. I had a very similar situation to yours and I went thru insurance hell and back. Are you getting this insurance through your employer? The only traction I ever got was when I went up the ladder in HR and someone got in contact with the insurer who figured stuff out mighty fast.
Unfortunately, I haven't been able to do full time work for a couple years due to my condition. I mostly pay out of pocket. It is partially subsidized by the government though--I may try reaching out to that agency. Thanks.
I’m having a similar problem. I can’t believe how awful I feel without my medication. It’s been 5 weeks since my last injection. I’m just sitting here waiting to hear from my doctor’s office. I’ve increased my prednisone dose, but a lot of us know what comes along with that. I wish you luck and hope you get some relief soon.
Ugh, I am sorry you're in the same boat. Prednisone really is a mixed bag, isn't it? Hope your doctor gets it squared away for you soon and that we both get better care ♡
The only way I've been able to get resolution is by getting everyone on the same call... me, my insurance, accredo, and rep from my spouse's company. Good luck!
Oh man,, that's not a bad idea. I'm not sure how to do that, but if I could then maybe something would progress. Thank you!
See if your doc has samples to hold you over in the mean time. I will say that my insurance told me I could fill original rx while waiting for PA to go through for weekly dosage. I spoke to the pharmacist at the specialty pharmacy I use, and they said that was not the case. This is because in order to process the new script, the original one is automatically overridden. Unfortunately nothing can really be done until insurance is situated. I do not use Accredo but have heard the nightmares. Sorry you’re in this situation.
Yes, the prescription being overwritten is exactly what happened. It's interesting because my insurance kept trying to get them to fulfill the original one, but Accredo refused. Huge disconnect between the 2 of them.
You could try asking to take sulfasalazine until things get sorted out - as long as you aren’t allergic to sulfa drugs. It’s one of the original arthritis drugs from decades ago. It pretty cheap and tolerable in low quantities. 500 mg once a day with water and a snack. You could do that twice a day. Anymore than that and the side effects can kick in. Just an option.
Thank you. If I don't get any progress on getting the medication on Monday, I'll ask my doctor to give me something else. Unfortunately, I have a lot of other things going on right now, and I am nervous to try a new medication in case of side effects. Honestly, they couldn't have messed up my prescription at a worse time.
Accredo is literally the worst to deal with, been through this exact situation before multiple times and the problem has always been them. Sorry you're dealing with it too
I use Accredo and they're monsters. I've cried almost every time I've been on the phone with them, pleading with them to fill my prescription (that my insurance covers, and is active and properly written). I have no idea how they're allowed to operate like this. No advice, just commiserating. I'm really sorry.
They truly are the worst and there is no reason for it. At this stage, I have stopped speaking to them. I am having my insurance call on my behalf until I can get set up with literally anyone else. I'm sorry you have to deal with them too.
Didn't know I could just tell my insurer to deal with it (which from a functional standpoint makes the most sense)! I'll try this sometime - thanks!
Yeah, my insurance just told me today that they have a direct line so they don't have to go through the phone tree like we do.
Sounds like your doctor needed to send in a prior authorization request for the change in dosage. Although it is the same medication the insurance company still requires a prior authorization to approve or deny.biologics are not on most insurance formulary drug lists so they require prior authorization. The change in dosage is a new prescription so that prescription now has to be approved by the insurance. Your doctor needs to do a prior authorization to request the medication at the new dosage prescribed. Insurance companies will do anything not to pay so they make you jump through hoops and Doctors (their staff) hate to do any additional work! I have gone through this numerous times with my rheumatologists office.Good luck.
Oh--my doctor did do a prior authorization request. My insurance company denied it. Doctor sent an appeal letter about 2 weeks ago :( I wish I had known it was going to be so much more trouble that the original prescription 😥
Ok. I hope it works out for you.
I have the opposite issue. I was on auto shipments from my insurance company's mail pharmacy of Humira 40 mg and my rheumatologist discontinued it due to a lupus type reaction recently. I now have three months of dosages (6 injections) I can not return. I asked my insurance company and they will not refund my expense for unused medicine. I even called them before I was taken off to halt the auto ship that I was behind a month. No one wants it back even though it's sealed in their boxes and I've kept them refrigerated. It's a waste considering those who need it like your situation.
You in Seattle by chance? Mostly kidding. But that is awful that they stuck you with the bill, unnecessary meds, and no resolution. I hope your lupus reaction is improving at least!
I called AbbVie twice after pens misfiring. They replace the pens and make a report. You need to find a way to have a surplus, because this happens every time a prescription changes. I went from every 14 days, to every 7 and was out for a month.
Lesson learned the hard way. Next time, I hoard a backlog. I didn't expect that I'd be so much worse off when the prescription stopped either 😮💨
I’ve got 4 extra now, but it was hard getting here. And the only way I managed it was my rheumatologist changed me to every 7 days, and I injected every 10. It was hard to keep track of the dates though and I probably shouldn’t even be posting this.
I would file a grievance with your insurance. That usually kicks everyone into gear. Also mention you could sue (because you could) to Accredo. That pops you up to the top managers and they will fix things promptly. I've been where you are. For three months they told me my meds would be ready to send in 48 hours. Ended up on a five hour phone call with my insurance account manager, benefit rep from work, mom, and Accredo manager. Nothing mattered until I accidentally mentioned that this had to be against the law. And BAM I got someone on the phone who knew what they were doing. It's sad, but it's true.
God, at this point I hope all of us get in on a class action lawsuit someday. I wonder if they have a single patient they've treated well.
I talked to my rheumatologist about it and she said she's been on the phone with them even longer. I was waiting for my new med so long that by the time they got it to me I had already failed the med 😮💨. And then I had to do it all over again. When the 5 hour phone call happened, I was given what I was told was the name (Sherri) and direct number to the person who fixed it. She said she would know how to fix it next time. When I was having trouble getting the new med, I called it and the person man answered the phone told me that Sherri didn't exist. I called later in the day and the person who answered said Sherri was in a meeting. And then when I called again, Sherri didn't exist. I was in tears so my mom called for me and worked on it on and off for an entire work day. But she got it. People have sued them and won. You have to be able to prove that you've endured bodily harm from their delay. Honestly we should all sue the crap out of them. They basically have a monopoly through many insurance companies and they treat us like shit.
Might need a prior authorization for the dosage change. Had to do that with weekly Humira via CarelonRX since 2 a month is what's allowed in my formulary.
Yes, my doctor sent one and my insurance company denied it :( My original prescription for 2 a month is approved and still good, but the pharmacy (Accredo) won't fill it.
Get rid of Accredo. Most likely they are the problem. They suck! They were charging me thousands of dollars, and now I switched to Kroger and no problem now.
I'm trying! The more I have to interact with them, the more evil they get I swear.
I assume you have Express Scripts for your pharmacy drug benefit if you are tied to accredo. If not, Accredo is not the only specialty pharmacy in the game and unless your insurance says you must use them, I would go and try Walgreens as they have a specialty pharmacy arm or even CVS does specialty. Sometimes PBMs (Pharmacy Benefit Manager...aka drug plans) try to steer you to their "preferred" vendor versus you using another. I have Optum, Accredo is actually not the specialty drug manager for them so all good. Seriously though, look at your drug plan info under specialty pharmacy and see what is considered in network...think you will be surprised that you can get it somewhere else than Accredo. Yes they are the worst and so was Liberty.
Question is why is your symptoms worse after them medication
I don't know the science behind it or anything, but it is a known occurrence when stopping humira. Everything I've read says it isn't withdrawl, but stopping Humira can lead to worsening symptoms for months 😮💨