Help choosing plan that won’t deny Trulicity

Hi there –

I am gearing up to have a 90 day gap in health insurance (my husband is changing jobs). Are there insurance plans on the NY marketplace that are more likely to let me keep my Trulicity prescription? I’ve been denied in the past so I am wary.

I’m ok with foregoing therapy and other regular appointments for 90 days, but I can’t go without this medication.

Background:

I am a T2D and have been taking Trulicity for the past 3 years. However, my last experience on the NY Healthcare marketplace led me to paying for 1 month of a health insurance plan, them refusing to approve the medication I was prescribed (I had been taking Victoza for 2 years at that point) and basically wasting my time/money. I immediately cancelled. My solution at the time was just to enter into a domestic partnership with my now-husband so I could continue accessing medical care. My husband’s old job hasn’t processed his resignation yet so we haven’t been able to see what COBRA plans might be availble.

I don’t want to end up in that situation again – it was very scary being without the medication I needed. Would love some guidance! OTC Trulicity costs ~$1k per pen and I can’t afford $4k/month for 3 months.

Age: 33

Zip: 11372 (Queens, NY)

Income: $160k combined (we each make $80k)

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