Why Does Insurance Not Cover Dupixent and Your Rights

Insurance companies often deny coverage for Dupixent because it's a biologic medication, which can be expensive to produce and administer.

In fact, Dupixent is one of the most expensive medications on the market, with a monthly cost of over $30,000.

This high cost is a significant factor in insurance companies' decisions to deny coverage, as it may be seen as a financial burden to the insurance company.

Insurance companies may also deny coverage for Dupixent if they consider it off-label, meaning it's being used for a purpose not explicitly approved by the FDA.

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Insurance companies may deny Dupixent because it's not on the formulary list.

A shot of Dupixent can cost as much as $3,354, which might be a factor in the denial.

Insurance companies may also deny Dupixent if they don't believe the drug is medically necessary for your condition.

Your physician can prepare a medical exception letter to send to the insurance company, telling it the drug is medically necessary for your condition.

If the insurer still denies Dupixent, an appeal could be your next course of action.

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You have the right to receive medically necessary treatments, including prescription drugs like Dupixent.

Your insurance company cannot deny you a treatment that your doctor deems necessary for your health. In fact, they have an obligation to provide coverage for such treatments.

It's frustrating and frightening to receive a Dupixent insurance denial, especially if your doctor believes it can significantly help your atopic dermatitis.

You have the right to receive medically necessary treatments, including prescription drugs like Dupixent, from your insurance provider.

Your insurance company has an obligation not to deny drugs or treatments that are medically necessary for your health.

It can be frustrating to deal with a huge corporation like an insurance company, but having a lawyer on your side can make a big difference.

If you've received a Dupixent insurance denial, a lawyer like Scott Glovsky can help you get the prescription drug you need.

Inappropriate drug denials are wrong, and a lawyer can help you fight for your rights.

Contact a lawyer like Scott Glovsky and his team if you need help getting your Dupixent prescription approved.

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If your insurance company denies your Dupixent prescription, don't worry, you still have options. You can file an appeal to contest the denial.

Your first step is to review the denial letter to understand why the request was rejected. This could be due to insufficient documentation, the patient not meeting the criteria, or the insurer suggesting alternative treatments. It's essential to carefully read the letter to identify the reason for the denial.

You can then contact the insurance company to request more detailed information to address their concerns. This may help you gather the necessary evidence to support your appeal.

To file an appeal, your office can submit additional supporting documents, obtain a second opinion from a specialist, or provide further clarification about why Dupixent is medically necessary. This may involve gathering more information from your doctor or specialist.

If the insurer remains firm in its denial, you may request an external review, where a third-party medical professional will evaluate the case. This can be a crucial step in getting your Dupixent prescription approved.

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Insurance companies can be quite strict when it comes to covering new and expensive medications like Dupixent. A shot of Dupixent can cost as much as $3,354—or more, in some cases.

Insurance companies may deny Dupixent prescriptions because the drug is not on the formulary list. Your physician can prepare a medical exception letter to send to the insurance company, telling it the drug is medically necessary for your condition.

The cost of Dupixent is a significant factor in insurance denials. If your insurance company denies Dupixent, an appeal could be your next course of action.