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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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