New Insuance Denied My Linzess Rx B/c I Don't Have Cancer!

Updated

I have been on Linzess for over a year now, and happy enough with the results. I had been covered through Blue Cross/Blue Shield of NC. There was NO problem getting the rx filled. Now I am covered through BC/BS of Minnesota. I received a letter denying the rx stating that I am not eligible because I don't suffer from active cancer pain! What the heck are they talking about?!?!
Has anyone else run into this kind of issue with their insurance??

3 Replies

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1

Appeal it and they might.
Your doctor may have to do a prior auth, but I would fight it.
I have before with other meds and other insurance and it works.

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2

Re: Optimistic (# 1) Expand Referenced Message

Thanks for your reply. Unfortunately I have already appealed and I have still been denied.

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3

That is very odd, since Linzess is used to treat IBS with constipation, and idiopathic chronic constipation.

I wonder if it's possible that they are confusing it with some other medication, or have it listed incorrectly in their formulary?

Have you tried calling them to speak to someone directly?

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