I have been fighting very hard with lupus since 2004, but most especially since 2013. I have been in and out of the hospital 11 times. My doctor started me on Benlysta February 2014, and it takes a long time to see a positive effect, but we finally did in October. Benlysta only comes in two doses - 120 mg and 400 mg. This is important to note. Also important to note is that my weight fluctuates wildly due to the fact that lupus is in my intestines. I was very ill in December and January, and I lost 40 pounds very quickly. In April, Blue Shield retroactively denied my Benlysta dosage because of my weight. They said I only needed 80 mg. This would barely cover what I needed, not allowing for any fluctuations in weight due to massive steroid IVs during hospitalizations or anything. My doctor and I fought all the way to the state, and the insurance company narrowly presented their defense on FDA terms. Their denial is *not* about dosing. It's about cost cutting. Benlysta is billed at $18,253 per month. That's what it would cost me without insurance. What my insurance pays is a little over $3,500. What they aren't paying right now, what is left over, and what I can't pay, is $2,300. Please help me stop Blue Shield from denying me life saving medication. In the three months since I've had not had it, I've only gotten sicker, had more flares, and ended up in the hospital again. My last hospitalization was billed out at $55,000. It cost Blue Shield $21,000. Tell them to stop cutting corners. Tell them to stop using Fail First and Step Therapy, because it might save them money, but it hurts their members.