Insurance is no longer covering the cost of a medicine that my father needs. Anyone ever deal with something like this? Not sure what to do. I’m not trying to get stuck with the bill (I’ve dumped so much money for them), but trying to understand if anyone has had any luck appealing?

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Tell the doctor about this medicine that is longer covered and see if they can offer an alternative. The insurance company also will suggest an alternative medication if they don't cover the cost. Reach out to the drug company, request vouchers or discount.

See if there is a generic or something similar. Call the insurance company and see what medicine in the same family they cover

This doesn’t always mean they won’t cover it - there’s likely a TPA who administers the rx side of the insurance. Should be an appeals process / review process or Dr can write a letter that other meds have been tried and failed etc. Also many name brand drugs offer discount programs - go to the drug’s website, and there should be a page about affordability, discount programs etc. Might also look into the company “Cover My Meds,” to see if that helps if your dad qualifies. Another option is the “goodrx” program. I have used goodrx discount card (free to get one) on rx’s in the past. You ask the pharmacy to run the rx through without insurance using the goodrx discount. Many times it’s cheaper than the copay on your rx insurance.

I used to take an acid reflux med called “dexilant” but used the coupon from their website discount program and only paid $20/month for it, it’s normally hundreds of dollars.

I am really sorry to hear that OP. That is so frustrating and I know that battling an insurance company is no fun. Best of luck to you appealing that! They should definitely cover it in my opinion.

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