My Co-Pay Jumped Up
I went for a mini vacation over Thanksgiving to visit my son and his family in Maine. I was out of my Symbcourt, or just about out, so the following Monday after Thanksgiving I went to my CVS pharmacy and picked up two prescriptions that where prescribed. I was told to start when I got home. So I picked that up and Methylprednisolone, which works just as good as prednisone, which I can't take.
I went to the drop off window and asked for them to fill it for me and I will pick it up in the morning when I came into town to get groceries. As he was looking up my info he asked if I had changed insurance companies of changed my co-pay. I said no to both. That's when he told my my copay, which was $60, went up to $108 dollars. I was stunned. I can't afford that and point blank said that is highway robbery. I told him to forget it and went home.
I called my insurance company and they said that my deductible is now 25% of the total drug cost. She gave me the name of a company that would pay up to 80% of the drug cost. So, Wednesday after work I went back and tried again. No, I could only use my health care of the card not both. So I ended up paying the $108. I called my doctor's office and told the pharmacy people I needed a new inhaler for next month as I just picked up this month's. No one listened to me. When I went in to pick up my cholesterol meds I had Sprevia waiting for me. I declined as I just filled my Symbcourt. Have a physical on the 19th and will hash this all out.
Good morning,
I'm truly sorry to hear about the unexpected increase in your copay for essential medications. It's disheartening when such changes catch us off guard, especially when it comes to our health. It's frustrating to face these financial challenges on top of managing your health. Navigating these insurance intricacies can be overwhelming, but your proactive approach in seeking alternative solutions is commendable. It's unfortunate that the initial attempt to pick up your prescriptions didn't go as smoothly as one would hope. It certainly will be a good idea to bring this up at your upcoming physical -- perhaps your doctor will have suggestions to help you get the medicines that you need. Remember that you are not alone in facing these types of insurance/copay issues here in this community (as I've had my share of issues myself). Please do keep us posted how it goes for you moving forward. Wishing you all the best. John. community moderator. 
Hi. Just to clarify, were you told about GoodRx, or some other kind of prescription savings program? I am assuming that the benefits offered by this program weren't as good as the savings from using your insurance.
I also wonder if you may be able to reach out to the manufacturer for assistance, as many of them offer coupons or one-year savings agreements. Regardless, we support whatever you choose to do and I really hope that you can figure something out with your doctor. Best of luck. I feel like we've all been there! -Melissa, asthma team
My insurance on symbacort went up 100% so I have no choice to stop taking it. I stopped it 5 days ago and no ill effects yet. The insurance is also going to stop covering it altogether which caused me to change insurance companies. February 1st it goes in effect and if I'm still doing OK I won't take it anymore. Good rx wasn't a help or any other programs
Thanks for taking the time to share your situation. I'm sorry to hear that you have to stop taking a medication that has been working for you due to changes in insurance coverage. Can you check in with your doctor to see if there is a similar medication that is covered? What do you think? -Lauren (team member) 
Hi
, and thanks for telling us about your present situation with the medication, Symbicort, based on insurance coverage. When this happens, it can be extremely challenging for the patient. This is so, not only because of the financial burden (which is of genuine concern), but also, because the medication which has been effective must be changed or stopped, as in your case.
I wanted to share a similar circumstance which happened to me. Last month, I was advised by my insurance company, that they would no longer be covering the medication, Advair, in 2024. I have have been using this medication successfully for all these years. What a blow that was to hear! However, the letter also referenced several other medications (as alternatives to Advair), which they would, in fact, cover. My plan is to discuss this with my physician and together, we will select one of the covered medications to try.
Have you had an opportunity to discuss your plans with your doctor?
Leon L (author/moderator asthma.net)
