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Health Insurance Won't Cover My Only Two Prescriptions

If you are a Marketplace expert, I need your help.

Beau started a new job in January. Yay. So we have United Healthcare through his job. Yay.


Except they won't cover my birth control (I use the generic patch), and they won't cover my Pentasa (what I take for Crohn's).

Beau is going through the appeals process on my birth control. We've paid for it out-of-pocket twice now, $85 the first time and $100 the second.


We just found out today that they won't cover Pentasa, when we tried to pick it up after work.

It's over $500 out-of-pocket.

There is not a generic version of Pentasa.

United Healthcare thinks I should discuss other prescription options with my gastroenterologist. They listed several alternatives.


I've been taking Pentasa since I was about 10. I'm almost 28.

So we're about to start yet another appeals process to get my Pentasa covered. In the meantime, I am without drugs to maintain my incurable disease that is already not very happy right now. But it's much better when I take my Pentasa two times a day like my doctor prescribed.


But we're also trying to figure out if I can apply for my own health insurance via the Marketplace, even if Beau's company provides health insurance. So if any of you are Marketplace experts, I could use your help.

We live in Georgia now, by the way.

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