Optum denying Descovy coverage
I have been taking the medication Descovy for HIV prevention since 2019. I did attempt to convert to generic Truvada in early 2021, when my insurer required everyone to switch to the generic. However, my serum creatinine doubled in a week, and I got a prior authorization. Since then, I changed jobs, moved from Minnesota to Ohio, then in May, moved back to Minnesota. However, my employer refused to update my insurance to Minnesota insurance when I moved back.
Today, I received a PA denial for Descovy because it is a plan exclusion. However, per US S.3295, which was signed into law in late 2022, not only must health insurance cover PReP, it must do so at no cost to the patient.
I called Optum’s PA line, and it was confirmed that Descovy is a plan exclusion. I was directed to call the Ohio Department of Insurance Office of Consumer Affairs. However, like I stated before, I don’t live in Ohio, and I’m an on-site employee in Minnesota.
What can I do to get this medication? I’m still at risk for HIV, and my risk has increased since returning to Minnesota. I need this medication.
