Attention Xeljanz Users!! New Alopecia classification leading to denial of coverage

Bad news for those of us using Xeljanz with health insurance. In August of this year, health insurance companies - Blue Cross Blue Shield Care First, specifically - reclassified Alopecia as a cosmetic/ aesthetic condition, rather than a medical condition/ disease. Consequently, they will no longer cover Xeljanz treatment because it is deemed cosmetic.

I'm considering suing. If anyone else has had their coverage of Xeljanz recently denied (since August 2019), please let me know.

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Permalink Reply by Susan S on January 21, 2020 at 12:37pm

Oy, so far no luck. But I'll keep trying.

Permalink Reply by Apple on January 11, 2020 at 12:18pm

YES CALIFORNIA INSURANC BLUE ANTHEM DOES NOT COVER ANY OF MY APPOINTMENT, TX, LABS OR OTHERWISE. THEY HOPE WE JUST DIE, THEY REFUSE TO COVER MEDICAL NECESSARY MEDICATION.THEE IS A LAW CALLED GALLEGOS LAW- THAT SAYS MEDICATION SHOULD BE AFFORDABLE IM SEEKING LEGAL COUNCIL. LOOK IT UP AND WISH ME WELL.WITHOUT MY MEDICAL NECESSARY MEDICATION MY LIFE IS NOT WORTH TWO CENTS. SENDING LOVE AND LIGHT!

Permalink Reply by Apple on January 22, 2020 at 8:41am

I have an am seeking legal advice form an attorney in my area about starting legal actions against advantek blue anthem blue cross.

Permalink Reply by SabineTawni on February 2, 2020 at 12:24pm

Please keep us posted concerning what your attorney says.

Permalink Reply by TurboK on January 23, 2020 at 1:25pm

I work for one of the major health insurance companies, and with the installation of Obamacare, my Alopecia and Psoriasis both became considered to be cosmetic. However, they still cover Viagra, which to me is more a cosmetic problem than Alopecia and Psoriasis.

Permalink Reply by Susan S on January 24, 2020 at 8:52am

So it seems major insurance companies are run by men for men. No surprise, just like the rest of the world, women are second class citizens. Yes, I know men have alopecia too but I believe a bald man is nothing near to the emotional stress of a woman losing here hair.

Permalink Reply by SabineTawni on January 24, 2020 at 2:32pm

First of all, alopecia areata and psoriasis are not "cosmetic".  They are real autoimmune diseases that have real health consequences (both physical and mental).  Secondly, insurance companies have always covered "cosmetic" damage caused by accidents, injuries, diseases, illness, and birth defects.  I know because I know of people who had that damage covered (including myself).  When did this stop?  We need to pursue this issue with everything we have.  Insurance companies are just in it for the money, and they make that money by denying, limiting, and restricting care.  We cannot allow some dim-witted twit from an insurance company to be making medical decisions about what constitutes a disease, and what does not.  If anything, they should be sued to practicing medicine without a license!!

Permalink Reply by bibby on January 28, 2020 at 8:05am

Absolutely correct. I believe alopecia is equal to the cosmetic damage caused by scars etc and people need to find a legal precedent to hold them to account to cover prescriptions. Outrageous behaviour considering the premiums people are paying. 

Permalink Reply by sampeckard on December 29, 2021 at 5:16am

At the age of 59, I developed this disease. I've been bald for five years, and I'd say I don't look bad at all. My wife likes it a lot, so this news didn't affect me. It would hurt me a lot of expensive medical supplement insurance; I already have it for the second year from https://www.medisupps.com/medicare-supplement-plans/medicare-supple... at a reasonable price. I'm well insured with minimal cost. I don't pay for doctor's visits unless it's a more expensive treatment.

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