“Medially” Speaking

My next infusion is scheduled for Friday. I knew my insurance company would deny coverage again, but getting the letter still made me angry, especially since it was so poorly written. Highlights include that Ocrevus is “not medially necessary,” (my spell check underlined that one immediately, suggesting “medically”—imagine that!) and that my request “has been thru” appeals already. Thru? Really? It’s starting to feel like fast food drive-thru medical decision-making, certainly. Do they not have spell check there? A copy editor or two? When you’re making decisions about people’s lives, why not put the effort into at least looking like you give a toss?

I don’t know how long Genentech will cover Ocrevus for me. I also don’t know how long my insurance company can deny coverage unless I fail on two lesser medications first. Their position is that since I haven’t tried these medications, I don’t know that they won’t work for me, despite their being scientifically proven to be less effective than Ocrevus at preventing relapses. After having two devastating relapses in six months, why should I have to play that game and do more permanent damage to my body? What if insurance companies told women that they would not be eligible for effective birth control until they tried the pull-out method and failed on it, getting pregnant first? It doesn’t make sense.

The uncertainty of a future with MS is more than enough. The uncertainty about whether the treatment currently working for me will remain within reach is torture. I keep having nightmares that I’ll show up to my infusion on Friday and be turned away, especially since I haven’t heard from Genentech that I’m definitely covered. Maybe the real nightmare will be getting the infusion and then receiving a $100,000 bill for it. What “medial” interventions would be necessary then?

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3 thoughts on ““Medially” Speaking

  1. Eileen Botelho says:

    Erin
    Reading this makes me angry as I’m sure going through it does you 😦
    On the other hand I had to chuckle at those grammatical errors in the letter 🙂
    Hopefully all is well when you arrive for your infusion on Friday.
    It should knot that hard two make them sea that you knead this medication!

    Liked by 1 person

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