1. United States
2. Ill.
3. Letter

I’m a long Covid patient. I’ve had a lot of fatigue, brain fog, fainting, gastroparesis, jittery nerves, & couldn’t read books for 3yrs. I was recently evaluated @ Northwestern long Covid neurology clinic. During this appt, they discovered I had some cognitive decline & prescribed an old antiviral called amantadine. The format that I received @ the pharmacy was a tablet. UHC manages my part D benefits. When I went to refill the prescription, the pharmacy said the tablet was not covered, but the capsule was. I learned the capsule has one of my documented allergens. So we did a prior authorization for the format that I would not be allergic to which is the tablet. They denied it so I filed an appeal by phone & explained everything about the medication. My doctor tried to prescribe another medication & it got denied. Since I started the amantadine, I’ve been able to start reading books again, have less fatigue, have less brain fog, have more sustained energy & more sustained attention. I only have a few more tablets left b/c I’ve had to skip the med while waiting on a favorable decision. Multiple studies are finding this medication to be helpful for Covid fatigue. Everything prescribed for Covid is going to be considered experimental!!! Under the Americans w/Disabilities Act, allergies are a disability. UHC has the medication on its formulary, just not the format that I’m not allergic to. The initial denial was b/c all they were taking into consideration was that the medication has been used for Parkinson’s disease. They didn’t look at the fact that it’s an antiviral. Since I’ve had to skip doses, I’ve had setbacks. As mentioned before, everything prescribed for Covid & long Covid is going to be experimental, but it’s all doctors know to do right now. My particular drug plan is considered above baseline in Illinois, which means I have to pay a premium, even though I am in the extra help. My insurance shouldn’t be overriding my doctor. I heard the press conference re the pending healthcare reform bill, making it through the capitol. It sounds great, but please keep dually covered Medicare beneficiaries in mind as well. I have Medicare part A, B & D, champVA & Illinois Medicaid. I need my medicine. We don’t know how long for. I didn’t find out about my positive long Covid diagnosis until after the recover Covid study for my area was closed b/c it’s full. I don’t have time to wait to see if a study can take me. I’ve been fighting for my life for 3 years. This medication has lead to improvements & I renewed sense of hope. Please help.