u/FleeingGlory0

I take specialty medications and I was trying to find the clinical guidelines so I can determine if I should switch health plans to my new employers, instead of my parents plan.

I want to go onto a specific drug, but since insurance requires you to try others first it gets very complicated very fast.

I have UHC, with CVS as my PBM, but inside of that I have an additional PBM just for specialty called National Cooperative RX.

When I call them they say they will not tell me since the clinical guidelines are proprietary.

I'm not sure if I'm asking the right person, or if there is a different way to go about this. The clinical guidelines are not listed in my formulary and CVS does not have access to them.

I lived in Minnesota for a bit and had an amazing GI there who was attentive and responsive.

While in Nebraska I am now on my second GI who is impossible to schedule time with, and who feels like barely reads my chart, and won't actually do anything for my disease unless specifically asked. They then just throw me to their APPs who are out of their depth and prescribe the incorrect medications.

Does anyone have any good gastroenterologist practices or physicians they can recommend in the Omaha Metro?