December 2022

Member Stories: Meet Ms. N

When Ms. N received sudden notice her chronic gout medication would no longer be covered by her medical insurance, she knew exactly who to call: her own personalized care team at Belong Health. 

With no time to waste, and with the help of the CVS Caremark Online Client Care portal, a Belong Health pharmacist researched Ms. N’s claim and set out to resolve her concerns. The pharmacist soon discovered Ms. N’s medication, Krystexxa, was being paid out by MVP Health Care for $50,653.99 per month. 

There was simply no way Ms. N could shoulder that cost. 

The investigation continued with a personal and private chat with Ms. N herself, who admitted she had missed some doses of her medication because of hospital admissions and due to her own sense that Krystexxa might not be providing her symptoms with relief, after all. 

Was Ms. N’s medication not yielding the results it should? The Belong Health pharmacist connected with Ms. N’s prescribing provider for more details. Together, with further research, they concluded Ms. N’s hunch was likely correct: her urate levels showed little change as a result of the Krystexxa.  

With Ms. N’s permission, they decided to discontinue that medication. Belong’s pharmacist worked with Ms. N. and her nephrologist to find a more suitable alternative to treat her gout. As a result, financial claims for Ms. N were swiftly reversed. 

Now, Ms. N is on a new path to better health, as her provider orders more labs through which to study her condition, and as her Belong Health care team works closely with her to decide on new potential therapies.  

Much like her friends at Belong Health, Ms. N recognizes medical care is a deeply personal experience, not a one-size-fits-all solution. Together, they’re committed to finding an approach that works best for her.