Individuals impacted by pulmonary hypertension (PH) should contact their PH care team and specialty pharmacy if they anticipate changes in their health insurance in January.
Even health insurance provided through the same carrier may alter coverage benefits in 2020. Health insurance companies may remove medications from plan formularies or institute new prior authorization requirements. In these cases, a PH care team can help get insurance coverage for the PH therapy, but they may need to complete additional paperwork or even file an appeal.
Whether the change in health insurance coverage is big or small, individuals with PH can help their January refill go as smoothly as possible by contacting their PH care team and specialty pharmacy.
Pulmonary Hypertension Association (PHA) offers contact information for several specialty pharmacies that serve the PH community at PHAssociation.org/HELP or by calling 301-565-3004 x749.