Our drug plan comes under Tricare for Life. We jumped through one hoop after another, every time we’d get one done, oops you have another hoop. They even said they didn’t get the doctors paper work, called his nurse a liar. Made her hot under the collar. Took about a year.
Good for you in being persistent and sic'ing your senator on them. This type of behavior by is just plain wrong; the contract was sold as regulated by US law. (Although I would prefer that less of my money were confiscated and I had more freedom in how I purchase medical care and medication,)one has to deal with reality and the provider who sold the contract is bound by law.
I helped someone go through something similar; also went through the 'we didn't receive the info from the doctor' routine.(Wound up someone gave me the fax number for the initial request, not the appeal to the denial of the initial request.)
Along I came by information that was 'hidden in plain sight' that would have sped up things had I had it sooner. That is why I posted the
link in my prior post # 47.
Here's another
link that may help in the future. This regulates decisions by providers of Med D regarding coverage of specific medications, along with allowed time frames. You can browse forward and back as needed.
It amazes me that drug coverage providers are allowed to demand that you try other versions for synthroid which is one of a handful of medications in which generics, (and somethings even other branded versions of a medication) are not
bioequivalent.
Again good for you!