CVS Caremark Denying Herceptin Coverage
Hi Everyone,
I just received a letter from CVS/Caremark stating they no longer cover Herceptin unless it is in combination with current chemotherapies (only three types accepted). In other words, no long term use of Herceptin is allowed.
I have been on this life saving drug for about 9 years. I have been NED for five years. Devastated doesn't come close to my emotional state. I am obviously appealing the decision but I don't know how I can continue to receive the Herceptin pending my appeal. My Attorney General's office (MD) indicates there is no legal obligation for an insurer to continue paying for medication while an appeal is pending. Has anyone battled CVS/Caremark and won? If you have any suggestions for resources to help with the fight let me know. I can't believe insurance companies can make life and death decisions so arbitrarily?!
__________________
Missy W.
Diagnosed 1/06; Her-2, er/pr+
lumpectomy
4 Rounds A/C
tiny area of interest in liver - watching
12 rounds of Taxol w/ Herceptin
tiny area cleared - Stage IV (because area responded to chemo)
Herceptin weekly
27 rounds radiation
NED 8/06
10/06 oopherectomy
Arimidex
1/07-7/07 Vaccine Trial - UW Seattle
3/09 liver met back
3/09 Navelbine, Herceptin Aromasin
6/09 Liver Resection
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