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NYCE PPO Prime Therapeutics Hiv meds

hello all,

writing my issue is my last resort. After NYCE PPO switched the pharmacy from Express Scripts to Prime Therapeutics, I am no longer able to fill my rx for hiv med: Biktarvy. I have the Rx Rider. On Prime Therapeutics website the medication shows up as covered 90day supply for 50 dollar copay, but when I go to a pharmacy that is in their network for a 90day supply (my doctor sent a 90day supply) the insurance denies a 90day supply, (but on emblem health nyce ppo website it says i can get my 90day refill for tier2 meds) But the pharmacies (including specialty pharmacies) keep saying they can only fill 30day supply and it is with a copay $1800 per month. An impossible amount. Their call center people all say different things, I am being kicked in between the insurance pharmacy and the doctor and endless verification processes.

Is there anyone who can help me? I am losing sleep, I can’t even eat thinking the worst… Thank you in advance.

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