Co-pay increase

[creatingkarma]

I went to the pharmacy yesterday to get 3 of my meds refilled & about fell to the floor when they told me the total! I was expecting to pay my usual $20, but the total came up $120! The co-pay on my Zanaflex alone (generic version) went from $10.85 to $54.25! I asked the pharmacist why such a difference & she told me to call the insurance company. So, I did that this morning & I was told that I have met my limit for the year, so for the rest of the year I am required to pay HALF of the cost of the meds! This really stinks! :cussing: I don't want to give up any of my meds, but I'm afraid that I'm going to have to pick & choose which ones I keep & which ones I don't - especially the Lyrica because it costs so much!

[armslee]

Karma-
That really does stink. Are you on a group plan? I know that some groups are going to an RX limit now to reduce overall monthly costs.
Talk with your doctor. Sometimes they are willing to "float" you some of the samples that the pharaceutacle reps leave with them to keep you on your meds.

[Sarojini]

That's awful! But I do understand about Lyrica -- it's so new it's not on my dumb plan's formulary yet, and my copay on it is $50 a pop. YUCK. I'm right there with you beneath the pharmacy bills :grouphug:

[graceimnot2096]

Karma that really stinks. I have heard that if you call the pharmasutical companies that they will, depending on the situation, give you the med. I don't know much more about it, so far I have been fortunate that I have not had that problem.

[sunshine_77us]

Karma, I know what you mean. My synthroid now cost me 58.00. It went up because there is now a generic and all the doctors say not to take generic. My dr. has always put brand name necessary on that medication.

[ihurttoo]

(((((Karma)))) You poor thing! That really stinks! Before I got on disability, money was REALLY tight. I was on 22 meds at that time, and had to pick and choose lots of times too. My husband made too much for use to qualify for anything, so there was nothing else for me to do. I hope you are able to come up with a solution. Dont foget to browse the Low Income Assistance Boards, whether or not you are low income. There are many programs on there, that you may qualify for, regardless of income.

Also, if you have more than one more Dr, dont forget to ask ALL of them for samples. (Even if you just got samples from another one.) Even if you go to Urgent Care for a UTI or something, and see a Dr you have never seen, be sure to explain your situation and ask for samples. You can also write to the companies and ask if they can send you some samples with a drs. script.

Hope this helps! I do hope you figure out something without having to give up any of your meds. Hugs, Amy

[dancemomof2]

I had outrageuos drug costs also, until I got my new medicare prescription coverage now everything is $2 and $5. Sure was a relief.

[mary124]

That sucks. I'm right behind you all when it comes to costs of medicines. Hopefully, my insurance won't be doing that anytime soon, as I can't afford to pick and choose either.
Always, ask for samples, most doctors have samples of that medicine. (If it wasn't for one of our doctors office, my husband would have to pay out the--- for his meds, but thankfully, we have enough samples to last till sometime next year, and on another one, everytime I go in, I always ask for some samples. )

[creatingkarma]

Thank you, everyone! :grouphug: I know that my husband makes too much money to qualify for any programs. It's not that we can't afford the meds, it's just the principle. I feel like I'm being punished for needing so many meds, ya know? I have decided that I'm not going to quit taking any of them. I feel better than I did a year ago & I don't want to go back! I refuse to go back! My quaility of life is much more important than anything else we would spend that money on! I will be sure to ask for samples every time I see a doctor, though! Every little bit will help! My husband mentioned something to me about getting my meds through the mail. It's supposed to be much cheaper, so I'm going to look into it. The benefit office is sending me the info! Yea!

[traceann]

Hey Karma, I too have been meaning to check into my meds by mail, it is cheaper. I know that my company's website has a way to look up what it would cost in the pharmacy with the insurance and what the insurance by-mail program would cost. Most times for me, I could get 3 months worth for what it would cost me for 1-2 months at the local pharmacy... It's just getting together the stuff I need, lol, to get it started....

HUGS!!!!

[mary124]

In regards to the mail order, it use to be cheaper-- (use to pay for 2 months and get 1 free- now you pay for 3 and get 3) so it doesn't matter if I go by mail or to the local pharmacy. I for the most part it mine at Walmart- I think there are only 2 of them that I get thru the mail still.

[Dixiefireball]

Karma,
is the ins. company doing this to you threw the medicare part D program?? The reason I ask is because I got a letter telling me that also. Which i think is a load of crap. I feel the same as you. I feel like I'm being punished for needing so many meds.

I do hope somehow we can find a way to fight this.

sending you hugs and prayers.
Rhonda

P.S
I sent you a PM.

[creatingkarma]

Rhonda, no this is not through Medicare. It's through our insurance from my husband's work. I PM'd you back!