Ugg Declined after appeal following instructions

[vic120]

Did a policy with Aetna, A person was declined when I called they said it was due to 2 medications That come up for major conditions But they said if I got a letter from doctor's showing they were used for dif reasons they would approve

one was ropinirole They wanted to make sure it was not parkensons, Got a letter stating it is for Restless legs syndrome

The other I forgot the name but got a letter showing it was for skin condition nothing serious

Then they declined again said can't tell me why

She went to 2 docs and pain had to physically go in to get letters and now I have to call her and tell her declined and I can't give a reason

Has this happened to others, I know If I follow the instruction with Cigna I have always got approval but I can't get a good premium for her with Cigna

 

[David Taylor Jr]

I've not experienced this. Just curious, did the Dr. Letter say explicitly it was not for Parkinson's?

 

[vic120]

I've not experienced this. Just curious, did the Dr. Letter say explicitly it was not for Parkinson's?

It said I doc so and so prescribed this medication ropinirole for Restell leg syndrome and for no other diagnosis

 

[David Taylor Jr]

It said I doc so and so prescribed this medication ropinirole for Restell leg syndrome and for no other diagnosis

Hmm, that should cover it.

 

[goillini52]

Did a policy with Aetna, A person was declined when I called they said it was due to 2 medications That come up for major conditions But they said if I got a letter from doctor's showing they were used for dif reasons they would approve

one was ropinirole They wanted to make sure it was not parkensons, Got a letter stating it is for Restless legs syndrome

The other I forgot the name but got a letter showing it was for skin condition nothing serious

Then they declined again said can't tell me why

She went to 2 docs and pain had to physically go in to get letters and now I have to call her and tell her declined and I can't give a reason

Has this happened to others, I know If I follow the instruction with Cigna I have always got approval but I can't get a good premium for her with Cigna

I'd be curious to see if Union Security would take it.

Aetna's app, Aetna's RX KO list and Aetna is the TPA . Better rates too. Wouldn't that be funny if they took it.

Equitable National uses the same health questions as Aetna, but does their own POS PHI and has a different RX list. They also say the same for Ropinirole: treatment of Parkinson’s Disease is a decline. Instant decision, so you'd know before you go(hang up).

 

[goillini52]

Union Security was a new name to me for supplement coverage. Looking, I see it in KS too. Is that a brand new carrier to the supplements, or is it one of those periodic company renaming things?

edit
(I gave you a like on the post, not because I know anything about the carriers you mentioned but because it led me to some very interesting reading on imo's.)
end edit

It's owned by Assurant.

 

[LostDollar]

It's owned by Assurant.

Hey! Thanks for the response.

I'd just decided I should delete the post so Vic wouldn't get after me about hijacking his thread, but I appreciate seeing your answer.
LD

 

[goillini52]

Hey! Thanks for the response.

I'd just decided I should delete the post so Vic wouldn't get after me about hijacking his thread, but I appreciate seeing your answer.
LD

You're welcome and you weren't hijacking the thread LD. You asked me about a company I mentioned.

 

[vic120]

Hey! Thanks for the response.

I'd just decided I should delete the post so Vic wouldn't get after me about hijacking his thread, but I appreciate seeing your answer.
LD

All threads get derailed if they last long enough

I wouldn't get after you for that

Plus you didn't hijack the thread it was in line with the discussion

 

[vic120]

Ok had one of my FMO's call, Found out Ropinrol was excepted

The issue is tacrolimus They have for liver transplant but there is 2 forms one is pill which is for transplants but she does not take that one

The other is an ointment which is sed on the skin to treat a skin condition called eczema (atopic dermatitis) in patients who have not responded well to (or should not use) other eczemamedications.

But they don't want to hear it though