Drug Prices

Mom2Dogs · ‎03-09-2010

...major sticker shock on my husbands a-fib meds for 2017. The drug went from tier 3 to tier 4. We were told in November (Silver Scripts customer service agent) what the price was for 3 months for 2017....but when DH went to fill the script it was no where near that price!!

I would like to understand how drugs are priced.....if someone understands the in and outs I would appreciate a lesson, if not can you give me a web site that lays it out....in a non political way? Thanks

And ontop of the price increase he went in for his wellness check last year and just got the paperwork from the insurance company.....it was coded wrong and he was billed for the entire amount and to add insult to injury they billed him twice!

sidsmom · ‎11-25-2011

http://www.businessinsider.com/prescription-drug-costs-explained-2016-10

Gram W · ‎01-22-2013

@Mom2Dogs. The tiers of all my drugs changed in 2017. I dread filling the new RXs this month. They cost me more than groceries. Taking them is not a choice if I want to watch my grands grow up. I have been a widow for many years and I want to be independent and as healthy as I can be.

Two years ago I had a procedure billed under the wrong code. Both my specialist and insurance company understood. I was reimbursed quickly for the amount I had paid. All the paper work was redone with the correct code and I did not owe anything for the procedure.

I would talk to your facedoctors office and the insurance company immediately. It sounds like your doctor's office needs to reinvoice with the correct code and look into their double billing. I would keep a complete record of all conversations regarding this problem for future use and backup just in case. Some times others "forget" they discussed this problem with you and you will have needed complete information to jog their memory and protect your credit with all concerned.

Good luck.

Gram W · ‎01-22-2013

@sidsmom. Thank you for this information. It is very helpful.

Mom2Dogs · ‎03-09-2010

@sidsmom...thanks for the visual and web site....I will take the time to understand how this works!

and @Gram W....Monday morning the calling will start. This is not the first time I have had something coded wrong but the first time we were double billed on the insurance company paperwork. Ya gotta stay on your toes!

This is the 2nd full year my dh has been on any medication, it has been a learning curve, he got caught in the donut hole in November.

151949 · ‎03-09-2010

IMO - there is no one on earth who are dirtier dogs than Insurance companies. Who invented this krap of tiers of drugs? - they did. And, yes, as drugs become more necessary or more popular they move them up the tiers. Right now my DH is buying his diabetes drugs from Canada Pharmacy .com because of this. ( it's a very long story). Have you looked at buying from Canada - the government controls how much they can charge for drugs up there because the government pays for them under their health plan. I recommend you look into Canada drugs.com. It doesn't hurt to look! And it is the exact same drugs from the exact same companies as here.

Mom2Dogs · ‎03-09-2010

@151949...thanks. We have talked about it but not looked into it....I will assume you think it is safe.

Mz iMac · ‎07-26-2014

http://www.rxassist.org/

"Never argue with a fool. Onlookers may not be able to tell the difference."

Mom2Dogs · ‎03-09-2010

@Mz iMac...thanks. DH has a drug plan and we earn to much money to get assistance. Hopefully someone that can use the information will see it.

software · ‎06-08-2016

When my late husband was diagnosed with lymphoma, he got assistance from the Leukemia Lymphoma Society. It didn't matter your financial situation, you just needed something from a doctor comfirming the diagnosis.

They are huge into fundraising and they set aside some of that money to assist patients not just for research..

So whatever the diagnosis I would check with the local cancer society or whoever.

I donate to some of these myself and I like the idea that the money is used to help people who need it. Even if someone has money doesn't mean that they should be disregarded. A devastating diagnosis is the great equalizer. Your bank account should be irrelevent.

@Mom2Dogs wrote:
@Mz iMac...thanks. DH has a drug plan and we earn to much money to get assistance. Hopefully someone that can use the information will see it.