** Originally posted by ThomasF **
I have been responding very well to enbrel for the last 2 years. It is really the the best response I have ever had during a life time of psoriasis. I am almost totally clear. My employer's insurance (Caremark) has always covered enbrel. In fact, my last 2 insurance companies have covered it. Recently I got married and my wife and I decided to consolidate our insurance. Her pharmacy plan was also Caremark. Before switching I called caremark to make sure they would cover enbrel under her plan. I was told they would. On this basis I made the decision to switch. When my doctor called in the pre-approval yesterday he was told the claim was rejected and that I would receive a letter of explanation (something to the effect of alternative medication such as UV therapy should be explored).
So Caremark is forcing me quit enbrel cold turkey. I am p*ssed off of and a little depressed. I am trying to weigh my options (fight, try to get back onto my employer's insurance plan, some combination of both.) and understand potential risks (flare up from coming off the enbrel suddenly after 2 years).
I Would very much appreciate feedback and advice.