So my family was supposed to be on Medicaid, until 8/31. Our SNAP expired and it looked like from that Medicaid would be gone to. I started a new job and was going to get insurance through them anyway. The timing worked out. 9/1 my new plan took effect and the Medicaid stopped, or so I thought. Turns out Medicaid put us in an ease in program and extended us until February. Awesome, however here is where it starts to suck.

My wife has a monthly shot medication that is over $10,000 for psoriatic arthritis. She cannot move without it she’s in so much pain. New employer insurance is different insurance company than Medicaid plan. The primary will only fill the medication at the cheapest specialty pharmacy it finds. That pharmacy isn’t in the Medicaid’s plan of pharmacies they work with so they won’t pick up the remaining tab.

Medicaid won’t pay as the primary, and won’t pay that specialty pharmacy Primary won’t change pharmacies

I need to cancel my new employer insurance, or I’m left with around a $5000 bill every month, or my wife will basically just not be able to move. This is in PA and of course it would be a Highmark/ UPMC thing.

submitted by /u/Antique-Bet-6326
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