Insurance Won’t Cover Revlimid - HELP

lmbreen91 Member Posts: 1
edited February 23 in Multiple Myeloma #1


My aunt has been taking Revlimid for 4 years now. It has been covered this entire time, but this past month the insurance company stopped covering it. The doctor has completed and appeal. My aunt has appealed. The doctor completed a peer to peer. The insurance company just will not cover it. They also will not tell her what comparable drug is covered under the plan. The drug is $14,900 without insurance, so it's not like she can pay that out of pocket. She currently is insured through Maryland Medicaid and Maryland Physician Care.  

I have emailed the health commissioner, no response. We have contacted the manufacturer of the drug via phone and a financial assistance form, no response. 

Does anybody have any experience with dealing with the insurance company / how to get this covered? It's obviously medically necessary. I just need some information / pointing in a direction. I feel like everything we have done has been met with a dead end. 

Thank you.