Community Chat

[Drythe]

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@Kachina624 wrote:

@Imaoldhippie    Yes, there's a thread on Zantac.  It disappeared off the shelves several months ago so don't know what the big deal is today.

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@Kachina624 

The removal of Zantac was voluntary until today when the FDA made the removal formal.

[esmerelda]

@Jordan2  How many true symptoms of GERD do you have?  My PCP has been telling me for a couple years I have GERD because I occasionally/rarely have what feels like heartburn. I use OTC famotidine (?). 

[CalminHeart]

I'm on Medicare and have a separate prescription policy. Unless you pay through the nose, certain drugs have high copays.  I had 2 prescriptions with $100 copay on each. I could afford only 1 so was skipping the other (to my detriment).  GoodRX coupons took the copays down to $26 each.  I recently refilled them and the pharmacy still had the GoodRX coupons in my records and automatically gave me the lower copays.  I'm thrilled.

On the flip side, Medicare is a godsend.  It offers 100 times the coverage of my prior employer plan.  The total cost of Medicare, a supplemental policy, and an RX policy is $450 less per month than I was paying under my employer plan.

[Maestra1]

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@Jordan2 wrote:

I went to an ENT ( ear, nose, throat) doctor yesterday. I took care of my elderly mother, she fell back in October, went through a lot over three months ( she passed away). So back in October I developed an irritation in my throat which caused me to cough. I neglected myself, because I was so wrapped up with my mother. The doctor said due to stress he diagnosed I have GERD. My health insurance, Oscar said the medication Omeprazole 40 mg needs prior authorization. Well they said GERD didn't meet the criteria for the approval for the medication, so I was denied. The medication would have been zero cost to me with my plan. I had to go to GoodRX, and print out a coupon for the medication. It cost me $24 out of my pocket, instead of being able to get it for no cost to me with my insurance. I don't understand why acid reflux isn't a diagnosis for this medication? To anyone who has no medication coverage, always check out GoodRX before you go to the pharmacy.

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Consider yourself fortunate that your Rx cost wasonly 24 bucks. Many, especially the elderly, are on life savig meds and treatments that are nearly prohibitive in terms of cost.

Many people, including myself, often have to use GoodRx even with insurance. It's part of life...

[Maestra1]

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@Jordan2 wrote:

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@hayseed00 wrote:

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@hayseed00  the office called me this morning, I was told he did try to get authorization but they denied it. The thing that bothers me is I pay over $700 a month for the "privilege" of having this insurance. If I had bought over the counter Omeprazole it would have been the 20mg dosage, CVS brand for $24.50, so it paid to get the medication prescribed by the doctor.

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Just prior to Medicare DH and I were paying over $3000.00 A Month for health insurance.

[Jordan2]

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@esmerelda wrote:

@Jordan2  How many true symptoms of GERD do you have?  My PCP has been telling me for a couple years I have GERD because I occasionally/rarely have what feels like heartburn. I use OTC famotidine (?). 

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@esmerelda my throat is irritated, which causes me to cough ( I don't cough up anything), I also burp a lot, and my voice is hoarse so much so that people have noticed when they speak with me.

@Maestra1  I know $24 isn't that much money, but if I hadn't gotten a coupon from GoodRX it would have been much more ( with being quarantined money is tight). Also if I was approved for the medication by my insurance company it would have cost me $0!

[esmerelda]

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@Jordan2 wrote:

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@esmerelda wrote:

@Jordan2  How many true symptoms of GERD do you have?  My PCP has been telling me for a couple years I have GERD because I occasionally/rarely have what feels like heartburn. I use OTC famotidine (?). 

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@esmerelda my throat is irritated, which causes me to cough ( I don't cough up anything), I also burp a lot, and my voice is hoarse so much so that people have noticed when they speak with me.

@Maestra1  I know $24 isn't that much money, but if I hadn't gotten a coupon from GoodRX it would have been much more ( with being quarantined money is tight). Also if I was approved for the medication by my insurance company it would have cost me $0!

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@Jordan2  Throat irritation is a sign.  Coughing can irritate the throat. What came first? Usually throat irritation with GERD (aka acid reflux?) is caused by partially digested food/acid backing up into your throat.  Sleeping with your head slightly elevated is often suggested to prevent that. But you say nothing comes up when you burp. 

Assuming it's a correct diagnosis, did you ask the pharmacist if there is anything OTC like the Rx that you could take?  I'm guessing you got generic to start with. 

Big leap here but worth considering...when is the last time you had your heart checked?  A small persistent cough can be a sign of trouble. 

Good luck to you. 

[Jordan2]

@esmerelda the irritation came first then the cough. If I bought over the counter medication, it would have been only 20mg as compared to the 40mg, and the cost was pretty much the same.

[Blahblahvampemer]

Be sure to limit your time on any PPI drug as they do a lot of damage to the immune system, and omeprazole seems to be tied to dementia.  The cause of my dad's may well be using omeprazole all these years.  

[Jordan2]

I got a letter today from my insurance company explaining the denial of my medication. They said I should try over the counter Omeprazole first. The OTC is 20mg I was prescriped 40mg. The letter went on to say I could pay for the medication myself. I feel the insurance company just doesn't want to pay for it period (they won't pay for OTC meds and if I had been approved for the prescription it would have been $0 cost to me). For the amount I pay for my premiums they should be ashamed.