Ginger Martin, C.
From $0.00 to $1800.00 in a month and no one will tell me why
Express Scripts is the pharmacy for my Part D Medicare coverage. After a year of being on Wegovy due to “risk of cardiovascular disease and events” with proof of past myocardial infarction and a stent in the artery in my lower left ventrical, Express Scripts stopped coverage of my medication at the highest dosage level and left me in horrible stomach cramps and nausea at the age of 75. My doctor turned in the same prior authorization in accordance with FDA guidelines as he submitted a year before when Express Scripts granted coverage ( your heart never “heals” from a heart attack- the scarring and dysfunction is permanent); but Express Scripts denied my authorization and continues to do so. After contacting a patient advocate explaining that I was not even allowed to titrate down so as to not have this terrible pain, Express scripts sent a fake “sympathy” letter and promised two prescriptions to cover me until I could be re-evaluated. I eagerly filled out the paperwork through tears and had my doctor submit the two prescriptions; only to again be promptly denied due to “no prior authorization”. This company is evil and cruel. They have turned over authorizations to Innovative Solutions, robotic evaluators that only grant a percentage of authorizations for expensive meds whether you qualify or not -just like United Healthcare was doing. We have to use Express Scripts because they are the pharmacy for PEBA, my wife’s state insurance plan as a retired teacher; but if you have a choice, run fast and hard away from this cruel, mean company!

