For the past seven years, the Blue Cross-Blue Shield Federal Employees Program has paid for a medication prescribed by my physician at the Mayo Clinic in Rochester, Minnesota.

In February, 2012, the insurer refused to continue paying for this medication stating that it was not medically necessary.  I appealed this decision and was refused.  BC-BS has repeatedly failed to acknowledge why they paid for the medication for seven years even though they say it was not medically necessary.  This is a very expensive medication and I truly believe they are circumventing my rights as a plan member in order to save money.

I believe that a full investigation is necessary since the insurer has a history of paying for this medication and my doctor has repeatedly written letters necessitating its need. 

My physician at the Mayo Clinic said that this is beginning to happen on a regular basis to his other patients and that he is spending an inordinate amount of time attempting to help his patients -- often to no avail.

FYI, the medication in question is a specialty anti-fungal medication used to treat allergic fungal sinusitis and compounded by AnazaoHealth – a compounding pharmacy in Tampa, Florida.  Thank you for your assistance with this matter.