Insurance denied your child’s medication—now what? As a nurse case manager and mom, I was stunned by a $700 pharmacy bill for my daughter’s mental health meds. In this episode, I’m sharing five steps to fight a medication denial, from peer reviews and formal appeals to discount programs and patient assistance options.
Here’s the roadmap I used to transform that shocking “Not covered” moment into an affordable solution:
Get the exact reason in writing (never rely on phone calls alone).
Push for a peer-to-peer review—doctor vs. insurance doc can flip “No” to “Yes.”
File a formal appeal (it’s paperwork, but worth it).
Check patient assistance programs (sometimes cheaper than insurance).
Consider a healthcare advocate (because you don’t have to do this alone).
At Lumani Health & Unfiltered, we believe no family should have to choose between groceries and vital meds. That’s why 15% of our VIP memberships go directly to youth mental health—helping another child avoid the “Not covered” crisis.
Need hands-on help? Book a free 15-minute consult (link in the show notes). We’ll tackle your insurance denial or pharmacy bill problem and find a path forward—together.
Disclaimer: I’m a nurse, but not your treating provider—this is educational info based on my personal and professional experiences. For personalized medical advice, please consult a licensed professional.
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