Thursday, January 21, 2016

$700 Pills

This is what $700 of pills looks like,
and it is just a 30 day supply
of a medication I am on, likely for life.

In December, under my old insurance plan that
was generous, I paid $30 for the same 30 days supply.
Our company was too good to us and was going
to get fined for treating its employees to a Cadillac 
Health Care plan, one that we could afford.  
So they had to change the plan.

Now we have our prescriptions tied to the deductible.
Before it was a straight discount.
Now I have to meet $1,400 (individual) deductible before
I get a discount on my medication and there is no generic.
The manufacturer won their case to prevent generics
until something like 2025, or at least a long time.
The alternatives are just as expensive or require preauthorization.
Once I reach my deductible, and if I choose to mail order 
a 90 day supply at a time, it will be $125.  I can manage that.

So what do I do about the $700 prescriptions?
I looked up my medicine on line as advised by my 
pharmacy benefit provider.  The manufacturer has a discount card for
everyone that chooses to sign up for it.  It is not income based
but you cannot be on medicare, medicaid or other state or
federal medical plan.  They may have another program for that
but the discount card is for people with insurance.
If you have no insurance and are not on a plan I think 
there is yet another discount for you.
They will give me $500 off each monthly refill for 3 times.
Then they will reimburse me for a portion of my mail order
prescriptions- the pharmacy benefit mail order service does
not accept the discount card, which is fine. 
I just have to copy and mail in all my receipts
and fill out some type of claim form.
Hopefully they process refunds quickly.

That being said, the plan is not good but manageable
with the drug benefit card.   I suppose they don't just lower the
price since some insurance will pay much more for the 
fill and/or they are making more money when people don't know
about this card.  I wonder how much the medicine is in other
countries?  I"ll bet it is less.

So, if you have an expensive prescription and no generic alternatives, 
look your medicine up on line to see if there is a plan for you too.

I also took advantage of the $4 prescriptions that retail 
pharmacies have.  I went off insurance for my Pepcid (generic),
thyroid med and iron pills for 30 ($4) or 90 ($10) days.
I wouldn't even give them my insurance card so they don't file it.
It was going to cost $30 under my plan for one of the prescriptions
where it was $10 to go with the store plan.  They generally have 
a list of $4 or Free medications on their website.  I actually got an 
antibiotic free about a month ago. 

These days you have to shop around for the best deal!


Missy Shay said...

Wow, what a pain! I'm still paying the $3500 deductible for my surgery last year, in addition to paying the premium each month. The whole thing is stupid. I'm glad you were able to find a prescription discount.

Gorges Smythe said...

Personally, I think the heads of most drug companies are going to have an uncomfortable eternity.

LindaG said...

So depressing the way the government has 'helped' us.
You could check this out, too.
We used something similar for our son on Medicare. It cut a prescription that was over $150 down to $55.
His dentist's office has the cards there, too.
*hugs* and God bless, Kathy.

Lady Locust said...

Oh my. Our country is sure all about pharm. companies making their profits, isn't it. It is exactly why I don't support finding a cure for cancer. Two thoughts: why don't they find a cause then prevent it, and a 'cure' that doesn't involve a billion dollar industry has been discovered in Europe, but they block those sites in the US:)
Oops soapbox - I am glad however that you found a way to reduce the cost. $700 is quite a chunk of change.

Manny said...

Oh goodness Kathy, that's terrible. I guess the consolation is you meet your deductible faster, and then you get the discount. Keep well.

Yahoobuckaroo's Blog said...

Reminds of that guy in Missouri last summer who was uninsured when he got bit by a copperhead and had to pay $57,000 for anti-snakebite venom at Mercy Hospital.

deb harvey said...

i see that you have a gift for stunning understatement.

my husband's eczema spray is over 1000$ for a very small bottle. he is in agony without it. thank God for medicare.
used to be meds $$ would go down over time but now they go up.
daughter took relpax for migraine. pills went from about 12$ per tablet to over 50$ per tablet. she researched it and controls the migraines with magnesium and some other things.
do you remember a few years ago the 10$ shot that prevents miscarriage was bought and the price went to over 1000$ per shot?
caught between a rock and a hard place.

gorges has made a prediction about these greedy xxxx's and i think he may be right.

also ask your doctor about this; some pharma companies will give you free meds if you are poor. if you are approved the meds are shipped to your doc's office an you have to pick them up. just to be sure you are not cheating.
daughter got relpax through this program before she quit using it.

Powell River Books said...

We are fortunate to have a drug plan that is quite inclusive in the States, but when we are in Canada there is no coverage for us due to our income level. I remember the days when people crossed the border for less expensive drugs. Now it seems the trend has reversed. - Margy

Harry Flashman said...

My mom gets all her medications through Canada and the prices are infinitely lower. Can't you do that too?

Kathy Felsted Usher said...

I don't know if I can get mine through Canada, it would not be covered on my pharmacy insurance I'm sure because we have to use approved drug stores or mail order through them. I hear Mexico too.