Assuming this is post-Obamacare, do you know why your insurance didn't cover it? I had this simplified model that insurance covers everything once you hit maximum out of pocket and I'd love to learn how that model breaks down in practice.
It's intentionally complicated in order to fracture responsibility, avoid paying out claims and extract payment from publicly funded insurers.
The co-pays on tier 3 (i.e. super spendy specialty drugs) are crazy anyway, so insurance covering it wouldn't have really changed the affordability aspect one way or the other.
However, you may have to fight for it.
https://www.healthcare.gov/appeal-insurance-company-decision...
- the eli lily foundation pays for it anyway
- the older biologics have far more serious side effects profiles
Given that, it was kindof a no-brainer. I would have needed to go through the foundation anyway, since the co-pays on these drugs are insane regardless.