Choosing Inhaler or Not
I've moved over to the fixed income part of society and paying for asthma medication is now becoming a choice between breathing well or food and other bills.
The beginning of the year when deductibles on Medicare, my supplemental insurance and get this Rx coverage for all prescriptions class III and above. ALL inhalers are class III or IV a few even V. My duoNeb is in the same and needs a prior authorization. Still waiting on insurance to approve (first one since I switched) to Medicare and a new Rx carrier. If they don't approve the PA I will not be able to afford the duoNeb for my nebulizer.
I have a combo of in-home treatments which work most of the time now, keeping me out of the ER and hopefully admitted. It feels like the insurance companies are taking it backwards.
Right now it would cost me less to go into the ER and be treated. The problem is the Rx company still won't cover what I need to treat at home. They want over $800. I have been put in touch with a Pharmacy Case Manager to try and assist me. Even my daily inhaler I often don't use every day as my co-pay is still large. I recently found out my local pharmacy has found me a discount greater than my insurance carrier, by almost 40 a month.
As a senior and reading others stories I truly wonder if insurance companies are trying to do natural selection on a population through prohibitive costs. Earning a profit sure, pure greed at the expense of lives is......I will let you complete.
Oh
- In a few years I will be taking the same route as you and crossing over to fixed income. I am terrified. Your thoughts on natural selection on a population have crossed my mind as well. I can't imagine having to choose between food or medication. It's horrifying. I do hope the Pharmacy Case Manager can help you get the medication you need. Also, I'm wondering if your doctor's office has a sample they can provide you. It's truly scary how insurance companies are playing this game of "to breathe or to eat" with society. It's shameful and a disgrace to those who are struggling and suffering. You and the many others are in my thoughts. Hoping for change. Rebecca (team member)
Yes I got a months worth from my doctors office to help.
I also found out that you don't send your Rx for duoNeb supplies through your regular pharmacy, it's not covered there. On Medicare you send those Rxs to whomever supplies your nebulizer machine as that Rx is covered under durable medical equipment. Yeah, big learning curve once on Medicare what is covered by whom and what deductible does it fall under. Medicare, supplemental Insurance, then pharmacy deductible. Come the first of the year is my nightmare. At least I know know to get my duoNeb refilled in December even if I really don't need it yet, so I can push back some on that deductible.I do the same no matter the insurance - Fill any and all Rx's so that I have a month to figure out the insurance plan following the first of the year. Glad you were able to get your meds covered. How are you feeling currently? The end of summer and the beginning of Fall can be rough for many with asthma and allergies. Thinking of you. Rebecca (team member)
We are also on a fixed income and it's crazy what our medications now cost. I used to pay $10 for Breo with the manufacturer coupon. Then I went on Medicare and was shocked that it became $47 a month and after a while, it doubled in price for no apparent reason. My dr then put me on Trelegy (which worked great) but cost about $112. That went up to $118 then $128 and now it's over $130. That price is just not sustainable. I'm now switching back to Breo because it's still under $100 - even thought Trelegy is much more effective. Our system is truly screwed up.
Wow! What a relief. I'm glad that you and your doctor were able to figure out a way for you to afford the medication that best suits your needs. Thanks for sharing this! -Lauren (team member) Wonderful news! I've read of others turning to pharmacies in Canada to assist with necessary high-cost drugs. Thank you for sharing your experience with us. This is a daily struggle for many many people. Wishing you better days ahead. Rebecca (Team member)
