The complaint says the organization has charged large, out-of-pocket costs for drugs, placing almost all HIV medications in its most costly health insurance plan.
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Insurers generally get to decide what care is “medically necessary” and therefore covered. And that is often in the eye of the beholder. Insurers tend not to consider patient stress or family convenience in their decisions.
Sean Deines and his wife, Rebekah, were road-tripping after he lost his job as a bartender when the pandemic hit. But while visiting his grandfather in a remote part of