Share Your Story

Health insurance is broken: high co-pays, delays, denials, burdensome red tape, and murky PBM pricing practices can make accessing the care we need a daunting task, even when prescribed by our doctors. We are working hard to fix health insurance, and your stories can make a real difference.

Healthcare Costs

Q1: Are your out-of-pocket medical costs* unreasonable? *

*Out-of-pocket costs include deductibles, coinsurance, co-pays for covered service, as well as cash pay healthcare costs for services that aren't covered by insurance.

Yes

For what specific treatments or medications have you encountered unreasonably high out-of-pocket costs? What condition were they prescribed to treat?

Please describe the impact that high copays and other out-of-pocket costs have had on your financial situation, as well as the mental or emotional strain they may have caused. Have these costs led to financial hardship, affected your well-being or that of your loved ones, or forced you to make difficult decisions, such as forgoing necessary medical care?

Access to Innovative Medicines

Q2: Have you or a family member/loved one ever benefited from a new medicine or treatment like an immunotherapy or targeted gene and cell therapies? *

Yes

I don't know

What condition was this medical treatment or medication(s) prescribed for?

Please describe how this innovative treatment impacted your quality of life or the life of a loved one/patient (e.g. allowed me or my caregiver to go back to work, avoided hospital visits or long, expensive hospital stays, extended lifespan, etc.).

Why do you believe access to new treatments is important? How would limiting access to new treatments affect health outcomes for you?

Assessing the Value of Medicines

Q3: Have you or a family member/loved one ever faced challenges with insurance coverage for new or innovative treatments? *

Yes

How did these barriers impact your health/the health of your loved one?

Has your insurer ever denied or delayed coverage because of prior authorization? If so, what specific treatments or medications did they deny or delay? Please share your experience.

Were you eventually successful in securing coverage?

Yes

How much time did you spend attempting to resolve/appeal the issue with your insurance before abandoning your efforts?

Days

Weeks

Months

Years

Why do you think it’s important for patient perspectives to be considered in value assessments and healthcare policy decisions?

The Path Forward, Looking Ahead

Q4: Please describe what improvements or reforms to health insurance you wish to see. *

Q5: Are you willing to share your story publicly to advocate for policy changes? *

Yes

No, I wish to remain anonymous

Please populate one or more of the following fields that we can include as part of our awareness campaign to help illustrate the importance of these issues.

Phone

(###)

###

####

Name

First Name

Last Name

State of residence

Thank you!

PRIVACY STATEMENT

No Patient Left Behind values your privacy. All submitted stories will be anonymized unless you grant special permission to use your identifying information (see Q5).

We understand the sensitivity of health and insurance-related matters are committed to maintaining privacy and security. Thank you for your trust and contribution.

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