Community Chat

[Trinity11]

---

@softwarewrote:

---

@Trinity11wrote:

---

@Carmiewrote:

---

@softwarewrote:

---

@Trinity11wrote:

---

@Laura14wrote:

Go to GoodRX dot com to find the best price in your area.  We recommend it all the time at the pharmacy.    

Also, doing exactly what @151949 did by searching for coupons online from manufacturers or others can also help bring your price down.  

---

We have Caremark so we have to use CVS.

---

But isn't the price of the GoodRX meds cash, not through insurance?

You should be able to shop around.

Am I wrong?

@Trinity11

---

If you have Medicare Part D or a Medicare Advantage Plan, there is no reason to shop around.  Your insurance plan pays the price of the drug except for your copay.  

You are able to check your drug formulary and see what the copayment is.  The copayment is the same everywhere you purchase the drugs.

if you are in the donut hole, you will pay a higher fee.

---

@Carmie...I am too young for Medicare part D.

---

There is always a reason to shop around!

If I can get goods (meds) or service (dr. visits) cheaper using a discount card or plan, I sure will!   Every day of the week.

Example, years ago I had a $50 copay for an office visit with a specialist using my employer insurance.    At the time, his fee was $40.    I did not use my insurance.   Why would I pay a $50 copay when I can pay $40??   

Ii have insurance out the wazoo right now, but I'm not paying a high copay or deductible when I can buy off the insurance cheaper. 

---

@software...we have CVS Caremark (explained up thread) we have to use their pharmacy to obtain our insurance benefits. My husband's company contracted with them. Shopping around for both my insulins would end up in a $1800.00 bill monthly, even with Good RX.

[151949]

I never said I mind paying REASONABLE costs - I know I have copays etc. However, I do feel they need to be reasonable and I don't feel doubling the copay from one year to the next is reasonable.

I really feel our government NEEDS to be doing some legislation to get the drug companies and insurance companies under control. They are thieves with a license to steal. The more important the drug the deeper they stick in the knife.

[Annabellethecat66]

Well, I'll see you guys and raise you (isn't that what they say in cards?)  Ha!

What used to cost me $15 for one of the medications I take and I MUST take it now costs me $241 for a one month supply.

That's just one medicine every single month.  Then I picked up the steroids I'm now on (which I hate with a passion) and it cost me (are you ready).....$ .89 that's cents people!

[Carmie]

---

@151949wrote:

I never said I mind paying REASONABLE costs - I know I have copays etc. However, I do feel they need to be reasonable and I don't feel doubling the copay from one year to the next is reasonable.

I really feel our government NEEDS to be doing some legislation to get the drug companies and insurance companies under control. They are thieves with a license to steal. The more important the drug the deeper they stick in the knife.

---

What do you consider reasonable?  You knew or should have known back during open enrollment that your copay would double for your allergy meds.  Your drugs are still a reasonable amount for the insurance you pay for. You pay zero, nada, nothing for wonderful medical benefits.  You get free insurance for your gym, dental and vision as well as your medical care and your meds then complain about the amount of your copay on the meds. You have mentioned many times that you are saving $500 a month with your Advantage Plan.

You can always pay for better insurance if you don’t like what you currently have.  I have a much lower copay, but I pay a pretty penny for my insurance....and I very seldom use it.

I can’t remember when I last had to get an RX drug.  I pay for coverage that I don’t even use.

[mercyMe]

I feel for you.

My Savella is $415 a month ... funny, my insurance co. has no problem taking my monthly premiums, but when I need to use the insurance ... it's a big fat "No."

[Carmie]

---

@mercyMewrote:

I feel for you.

My Savella is $415 a month ... funny, my insurance co. has no problem taking my monthly premiums, but when I need to use the insurance ... it's a big fat "No."

---

I don’t know if this will help you or not, but many insurance companies have a list of drugs that they will not cover, but if you appeal they will.  These drugs require predetermination before they will pay for them.

Often  a person just goes to buy the drug and they are told it is not covered and they just pay for it out of pocket.  

Do you have the drug formulary list from your insurance company? It should list the drugs that require predetermination...all the expensive ones, for sure.

If you have not written a letter of appeal yet, you might want to consider it.  The worst that could happen is it still won’t be covered. You cannot call in an appeal, it must be done in writing and the insurance company must get back to you within 30 days or less. Predeterminations are handled much faster than that.

i used to work in the RX department of a health insurance company handling appeals.  Many were approved after they were initially denied.

[cherry]

I'm sorry I need meds . I would gladly contribute for others , who did have to get them,  even if I didn't need them

It's not great thing to need meds.  I appreciate the fact I can get some of the meds I need. It's better than nothing

[PinkSunset]

---

@151949wrote:

I never said I mind paying REASONABLE costs - I know I have copays etc. However, I do feel they need to be reasonable and I don't feel doubling the copay from one year to the next is reasonable.

I really feel our government NEEDS to be doing some legislation to get the drug companies and insurance companies under control. They are thieves with a license to steal. The more important the drug the deeper they stick in the knife.

---

look at it this way. You pay no premium for your health insurance while those on traditional Medicare pay a lot more than $108 a month, plus supplemental insurance to cover what Medicare doesn't. So you're ahead of most of us. 

To put it in perspective another way:

I ran into a friend today who served in Vietnam from 68-71. He told me he has been living with MS for a long time. I asked if he took medications. He said he used to be they gave him bad side effects. He said they have some newere drugs now but the VA won't pay for them.

So, a veteran who served his country cannot get medications for MS. 

$108 a month for allergy medicines is 1/3 of what I pay for medical coverage.  

[Noel7]

---

@Carmiewrote:

---

@151949wrote:

I never said I mind paying REASONABLE costs - I know I have copays etc. However, I do feel they need to be reasonable and I don't feel doubling the copay from one year to the next is reasonable.

I really feel our government NEEDS to be doing some legislation to get the drug companies and insurance companies under control. They are thieves with a license to steal. The more important the drug the deeper they stick in the knife.

---

What do you consider reasonable?  You knew or should have known back during open enrollment that your copay would double for your allergy meds.  Your drugs are still a reasonable amount for the insurance you pay for. You pay zero, nada, nothing for wonderful medical benefits.  You get free insurance for your gym, dental and vision as well as your medical care and your meds then complain about the amount of your copay on the meds. You have mentioned many times that you are saving $500 a month with your Advantage Plan.

You can always pay for better insurance if you don’t like what you currently have.  I have a much lower copay, but I pay a pretty penny for my insurance....and I very seldom use it.

I can’t remember when I last had to get an RX drug.  I pay for coverage that I don’t even use.

---

That’s how insurance works @Carmie.