Expensive meds | Imamother

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Expensive meds

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amother

Tue, Apr 09 2019, 8:43 am

My child needs to start daily medicine for a few years which will cost almost $100 for a thirty day supply. Does anyone have experience finding a way to get med cheaper or something? I have private health insurance in Lakewood.

Ema of 5

Tue, Apr 09 2019, 8:48 am

amother wrote:

You can try getting through Canada, but they don’t have all meds (they don’t have the Med we need) and not all providers will give a script.

ra_mom

Tue, Apr 09 2019, 8:59 am

Is $100 your copay? $1,200 a year?
Reach out to the manufacturer of the medication. Sometimes they have co-payment assistance programs.
Another option could be finding a different insurance that would cover more.
Sometimes Wal-Mart is cheaper without insurance than with. Call and find out their price on the meds.
Refuah Shelaima.

Ema of 5

Tue, Apr 09 2019, 9:06 am

ra_mom wrote:

I don’t know about the OP, but for us, we have a couple of meds that we need to pay for, but most are covered by insurance. I think it’s the long term daily meds (not all, but many) that people tend to have issues with, not antibiotics.
Another issue is that some meds (like one of the ones we need) have had production rates drastically reduced, so finding it is also very hard. We have to scramble every month to find.

singleagain

Tue, Apr 09 2019, 9:06 am

Try goodrx.com when I was between insurance they had some amazing deals. You put in the name of med and your location it shows you the cheapest places and it works with insurance

amother

Chocolate

Tue, Apr 09 2019, 9:09 am

amother wrote:

I'm also in Lakewood, and my child also is on meds that are about $100 for a 30 day supply. Private insurance, too.

Just to put things in perspective, that's not really expensive. There are people who are on meds that are in the $1000's....

Also, I find that the meds reduce my deductible dollar for dollar - unlike other medical services that only a percent reduces my deductible, or only what's reasonable and customary.....don't know if it's the same for you, something to think about.

You can try pricing it out at different pharmacies to see if it's a little cheaper somewhere else. Though I find the price can even vary slightly from month to month, because it depends on the supplier and the price the pharmacy got (as explained to me by the nice guy in CVS.)

Some companies will take what your insurance pays if you use brand name - I.e. they will give it to the pharmacy for that price, and take the payment from insurance - there's usually a special program you have to sign up for to do this. This didn't work for me because a) right now my insurance is paying zero, due to my deductible and b) they won't pay anything for the brand name of the medicine, and the company will only give it to you for less if insurance pays something.

At the end of the day, I try to be grateful that there is a medicine that can help my child, and the cost, while expensive, is somewhat manageable (I can't say the same for the rest of the medical costs....)

amother

Apricot

Tue, Apr 09 2019, 9:10 am

amother wrote:

Start the fight for approval.Even if takes long you pay menwhile and try. Im trying to make a non profit for meds and docs but its still a long way. Specially that Im not sure how I will keep funds coming in. It took me 4 months to have approval of one of my kids prescription. It was hundreds of dollars each month. My doctor is a good diagnoser and prescriber but when it comes to approval he is horrible. Use a mama papa pharmacy because they are nicer to deal with.

amother

Orchid

Tue, Apr 09 2019, 10:29 am

Always ask pharmacist how much it would cost without insurance. Sometimes it actually comes out cheaper!

amother

Aqua

Tue, Apr 09 2019, 10:30 am

I often work to facilitate people getting meds. Sometimes there is a commercial copay card, particularly if there is no generic. Additionally, based on your income and the cost, there are often patient assistance programs.
Meds can be very expensive.
Just so you know, my patients often take meds upwards of $1700/month.
They have Medicare and have a donut hole.
My dad was just written a prescription for $1200/month with insurance. (He asked if it is worth it at his age and he is only 70-that made me really sad).

Sometimes a script can be written for a similar med which is in a different tier, and therefore is at a different price point.

It seems expensive and overwhelming and I don't know your finances.

People are posting about 2 thousand dollar shaitals being the standard (not to mention $6000), and feeling that a facial for $75 and the $40 of product, is normal and so worth it. (Along with spending money on other waxing.....)

I am not looking to be argumentative or judge what others require for self care or spend money on, and obviously no one wants to spend money when insurance can cover, but looking at your finances, expenses and luxury purchases, along with it being a priority, can it be affordable? Is there a way to make or come up with $100 a month?

Wishing your child a refuah shelemah.

amother

Jetblack

Tue, Apr 09 2019, 10:35 am

I assume you asked the pharmacy.
My husband is on a mediation that costs $100 a month. We moved to a new pharmacy and it’s now $10 a month. The first time he went to pick it up they asked if we wanted to apply a coupon and now it’s way cheaper. I wouldn’t have believed it if it didn’t happen to us.

amother

Apricot

Tue, Apr 09 2019, 10:51 am

Yeah for about 6 months if you have comercial insurance you get very low copay. Like let say the brand name is nexium go to nexuim.com or if its depakot go to depakot.com

amother

Aqua

Tue, Apr 09 2019, 10:53 am

amother wrote:

Yeah for about 6 months if you have comercial insurance you get very low copay. Like let say the brand name is nexium go to nexuim.com or if its depakot go to depakot.com

It is usually 12 months and renewal every year, just need a new card-downloadable from computer.

amother

Royalblue

Tue, Apr 09 2019, 11:10 am

1. Google the name of the medicine. On the official medicine website, you may find instructions for getting a copay coupon or other patient assistance program. (My own medicine copay went from $100+ to $10 with a coupon). Websites such as goodrx.com, pparx.org and others can help you find the discount programs.

2. Ask your pharmacist. S/he may be familiar with discount programs and lower-priced similar medications.

3. Ask your insurance company. See how much the medicine would cost at various pharmacies in your area. The insurance company may have its own mail-order pharmacy, which may or may not be cheaper. See if your insurance covers other similar medications at a lower out-of-pocket cost.

4. Ask your doctor. Depending on the doctor, you may get the best outcome if you do your homework (steps 1-3 above) first. Then you can ask your doctor about whether lower-priced meds might be suitable (price varies from one patient to another, so you need to get that info for yourself) or to sign a form, etc.

It can be complicated. Be sure to ask plenty of questions. Good luck!

amother

Natural

Tue, Apr 09 2019, 11:14 am

I'm paying over $1,000 some months for prescriptions after coupons. $600 alone for just 2 of them. I had a cream that cost me $800, but only $3.49 after a coupon. Gotta love these high deductible plans. Maybe we can help if you tell us which medication.

amother

Pumpkin

Tue, Apr 09 2019, 11:31 am

try speaking to the manufacturer your insurance and a specialty pharmacy. a lot of them have payment options or help pay my child's medicine cost over $5,000 a month and there are so many different kind of assistance.

Cmon be nice

Tue, Apr 09 2019, 11:33 am

Try blink health https://www.blinkhealth.com/

amother

Apricot

Tue, Apr 09 2019, 11:38 am

Also if all fails I think you can apply for low tier pricing. I worked at front desk almost 10 years and sometimes we got those. Patients made an appointment and spoke to the Dr while in tue room with Dr. Then he brought out to us to help. I just dont remember if you initiate by calling your insurance or drug company. You make sure to say you cannot afford and want to formally apply for low tier pricing.

amother

White

Tue, Apr 09 2019, 11:40 am

Lots of good advice from people. Just wanted to add that--assuming these are long-term prescriptions--you look at your insurance options carefully when it comes to renew and calculate how different options will work out based on these prescriptions. I have a child on a very expensive medication--thousands of dollars for one month--but with the plan I got it works out that we have to pay it the first month of the year, but then we meet our family deductible and that DC's out-of-pocket maximum, so from then on that DC's meds are covered 100% for the rest of the year and the rest of us just have a copay.

naturalmom5

Tue, Apr 09 2019, 11:42 am

PM Fox... She is an expert on this. She wrote many threads about it..

SixOfWands

Tue, Apr 09 2019, 11:42 am

amother wrote:

Does your health insurance have a mail-order pharmacy? It's not worthwhile to use it for, eg, antibiotics, where you're only taking it for a few days. But every insurer I've dealt with has provided a 3-month supply for a single co-pay through its mail-order pharmacy. So it would be $100 for a 3-month supply.

Refuah shleima to your son.

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