|Change from Preventative to Non-Preventative
Apr 16, 2013
I also got the same letter from UnitedHealthcare. The employee account changed from a preventative benefit and the $35 copay per drug to non-preventative which now means full retail. We only are offered an HSA/HRA CDHP plan design so to Jay's question the financial impact is enormous. When they first started this medical coverage, it was not a preventative then for the past 3 years it was. I have filed an appeal and asked them to specifically address how it doesn't violate both ADA legislation (HIV+ as a protected class) as well as ERISA. When I called the Dept of Justice they said it was a gray area for a possible ADA violation but if the appeal is denied they strongly suggested I file an official appeal to the DOJ.
So it isn't any change in formulary, it is a change in benefit design...but interestingly enough low cost meds for hypertension and cholesterol were NOT changed.
| Response from Mr. Chambers
Thank you for expanding on that issue. Appealing is definitely the right thing to do.
Good luck, Jacques
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