No Coverage for Symbicort
My Medicare Advantage health insurance plan is being discontinued. I have been shopping for a new one on Medicare.gov. None of the plans available in my area will cover Symbicort or any of its generic substitutes. I am so upset that I feel like crying. Budesonide/Formoterol is the first treatment that really worked for me. I can't go back to how I was before, and it is going to cost me thousands of dollars next year. That will hurt, but at least I can manage it. I am truly sorry for those who can't. Health insurance is a necessary evil in the U.S. but make no mistake - they are evil.
Hi Jim, what an awful situation to be in. It seems criminal not to include a medication that has proven to work well for you. Are you able to ask if your doctor can appeal the insurance company? I'm linking an article that discusses how to get help paying for expensive medications. I hope this helps. How to Find Financial Assistance Programs for Asthma Patients -Lauren (Team member) It’s possible to go off formulary, in some cases, but it’s a process and the medication might be more expensive than if it were on formulary. I don't know how severe your asthma is. I currently take Breyna (generic Symbicort). It’s the most effective inhaler I’ve taken. Dulera takes a close second. I had to go through a process at the VA. They give everyone Wixela (Advair generic). Honestly, I don’t think that’s a helpful medicine. I had to have x number of “failed attempts” on Wixela at various doses before they’d allow my doctor to give me a medicine from the secondary formulary.
I’ve learned a lot about health insurance and the healthcare system in general over the past few years. I’ll leave it there…
Thanks so much for sharing this, Cassy. It's so hard navigating insurance issues, and strategy is such a big part of that. We really do benefit from one another's experiences here. Appreciate you! -Melissa, team member
I too just started Breyna inhaler. Symbicort generic. Feel somewhat better..
Hi there, thanks for sharing that the generic version is working well for you. How long since you started Breyna? -Lauren (team member)
When I started it, I tracked my peak flows. I there was an improvement 2 hrs after my first dose! Everything leveled out after 10-12 days. I don’t track peak flows every day anymore, but the times I randomly do, it’s been consistent.
I hope everything works out for you.
