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Old 07-25-2015, 05:41 PM
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DejaVu DejaVu is offline
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Join Date: Apr 2008
Posts: 1,521
15 yr Member
DejaVu DejaVu is offline
Senior Member
DejaVu's Avatar
 
Join Date: Apr 2008
Posts: 1,521
15 yr Member
Default Is there an appeals process?

Hi Brachial,

I am very sorry you are having to take up this issue. I am sure you have enough to deal with without this additional aggravation.

I had fought with Travelers for many years.
I had to keep every communication highly documented and had to send all info via certified letter, with a signature and a return receipt.
I had a supply of these postal forms in my desk, just for The Travelers Insurance Co. (I mean: I documented every call to them, from them, every letter -- incoming and outgoing, etc., in an ongoing file, for over 20 years.)

Is there an "Appeals process" available to you via your policy?
If there is, please use it. Doctors often must certify when someone needs a brand name drug. Observe the deadlines in any appeals process.

If there is not an appeals process, please contact your State Insurance Commissioner's office for assistance and/or direction on where to obtain further assistance. If the Commissioners office does not handle this issue, you may be referred to "legal aid" for assistance.

Also, immediately write a letter, with a copy to The Travelers and to your physician, stating your need for the brand version of your medication and also state you need to file an appeal on their decision to limit you to a generic medication. Send the copy to The Travelers via USPS Certified Mail, Signature Needed and Return Receipt. This way there will never be a question as to whether or not, and when The Travelers was notified of your need. Within this same letter, ask the Travelers IF there is an appeals process for you to follow, and ask them to outline that process to you, in writing, immediately.

My many different specialists are reporting increasing problems with many different types of generic drugs. and

Please move quickly on this, so no appeals deadline passes.

I hope this helps in some way.

To our Healing.
DejaVu
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"Thanks for this!" says:
Brachial6 (07-26-2015)