I feel you pain, literally. I had issues all last year going back and forth with Anthem Blue Cross for the same. When I got my insurance through the ACA approved exchange in my state I did my research, and verified the online documentation that Pentasa was a covered 'formulary' drug. Once my coverage started not only did they come back and say it wasn't covered, but the doctor visit I had to get the script
wasn't covered either. I went back and even talked to Anthem, at first they said they covered it then apologized that Expressscript
wouldn't cover and that was all they would do. I tried to get an exception by my GI didn't pursue it, instead he ordered a pill cam endoscopy that didn't get out of my stomach till the battery ran out. They say the Pentasa doesn't work, but after the hell I've been through since being off it I beg to differ. If I can offer any advice, as it's already been said, press your doctor to get the exception...press the doctor to contact Shire pharmaceuticals to see if they can provide assistance. Worst case solution, look into Canadian pharmacies. I wish you all the luck that they can help you.