Insurer refusing payment of drug Rituximab [View all]

Hello:

I have follicular lymphoma.

I have one more cycle after this last one.

My doctor has prescribed me the R-CHOP protocol.

One of the drugs part of this protocol (R)ituximab, insurance is refusing to pay for because the insurance company has deemed it as medically unnecessary.

According to the top rated Cancer Hospital as ranked by US News & World Report, (University of Texas MD Anderson Cancer Center, Houston):

The standard first-line therapies 
for follicular lymphoma are rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP)

https://www.mdanderson.org/publications/oncolog/a-new-era-in-follicular-lymphoma.h18-1591413.html

Insurance through your employer sometimes is not that great.

I have several options:
Appeal
File a complaint with the insurance commissioner office.
Get a lawyer

Thanks.