Make a Difference
For yourself
APPEAL DENIED CLAIMS
It takes time and effort, but where you can, don't allow your insurance plan to get away with denying you the care you need. Your care providers (e.g., physicians, nurse practitioners, and physician associates) can help with this, and Claimable is now helping patients get previously denied medical and prescription claims approved as well! You can check out their resources here.
For all
CONTACT YOUR LEGISLATORS
Our legislative representatives at both the state and federal levels look to us constituents to know what topics they need to make priority in their policy making. Until recently, legislative efforts to end pharmacy benefit manager (PBM) abuse had struggled to pass or, if they did, offered too many loop holes to be effective. Now, several legislative efforts to reform the health insurance industry are underway across the country and "on the Hill" in Washington, D.C., but our legislators need to know that we care and that this issue is CRITICAL! There are several ways that you can participate in this kind of legislative advocacy; click here to learn more.
SUBMIT COMPLAINTS
When your insurance fails you, there are people that want to know about it. Because health insurance companies and the pharmacy benefit managers (PBMs) they own/hire have rarely been held accountable for their abusive conduct thus far, patients filing complaint with their state's Department of Commerce (or similar department), the Centers for Medicare and Medicaid (CMS; if you're a Medicare recipient), TRICARE (if you're active military, a veteran, or a military family member), e.g., is currently one of the only ways that these entities are hearing about the horrors of health insurance. Our friends at St. Paul Corner Drug in St. Paul, MN have put together some helpful instructions for both patients and providers about submitting complaints like this here, and they update the page when they hear about new opportunities.
SHARE YOUR STORY
Those of us working in the pharmacy industry have been told time and again by legislators and government bodies such as CMS: even though we're impacted by PBM abuse, too, they want to hear from YOU. By sharing your personal story about your experiences working with PBMs/the insurance industry in general, you help us spread the word in a language others can understand and compel legislators and the government to enact critical legislative reform. Want to share your story? See the form below!
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