Insurance Increase for Budesonide
Moderators: Rosie, Jean, CAMary, moremuscle, JFR, Dee, xet, Peggy, Matthew, Gabes-Apg, grannyh, Gloria, Mars, starfire, Polly, Joefnh
Insurance Increase for Budesonide
I looked at my 2014 Rx plan for Medicare part D today. I'm with AARP United Health Care. Last year the level for Budesonide was lowered from a tier 4 drug (copay $90 for 270 pills) to a tier 3 drug (copay $40 for 270 pills). For next year, the level has gone up to a tier 5 level. Whether I purchase from a Preferred or Non-Preferred network, my copay will be 33% of the total cost. When I read that, I burst into tears. My 3-month prescription copay will go up to $930 next year.
I'm astonished that the copay would go from $40 to $930 in one year. I wonder if there is a big demand for the drug because GIs are finally properly diagnosing MC and prescribing Budesonide. Since they don't treat the condition by suggesting diet changes, many people are probably turning into long-time users like me, for different reasons.
Luckily, I have a 2-year supply of Budesonide at my present usage, and I haven't purchased any so far this year. I still need to get a prescription from my GI, who last year spent an hour trying to convince me to get a colonoscopy first. I managed to get the prescription without the colonoscopy, but I don't know how I'll fare this year.
Gloria
I'm astonished that the copay would go from $40 to $930 in one year. I wonder if there is a big demand for the drug because GIs are finally properly diagnosing MC and prescribing Budesonide. Since they don't treat the condition by suggesting diet changes, many people are probably turning into long-time users like me, for different reasons.
Luckily, I have a 2-year supply of Budesonide at my present usage, and I haven't purchased any so far this year. I still need to get a prescription from my GI, who last year spent an hour trying to convince me to get a colonoscopy first. I managed to get the prescription without the colonoscopy, but I don't know how I'll fare this year.
Gloria
You never know what you can do until you have to do it.
Gloria,
I've been afraid that was going to happen. I'm just guessing, but there's a good chance that it has something to do with the fact that major parts of The Health Care Reform Bill, aka "The Affordable Care Act" are finally being phased in over the next few months. The details remain hidden of course, but it appears that the insurance companies and pharmaceutical companies may have been pretty much granted a license to steal, under certain terms of the bill, in order to obtain their support for other parts of the bill. Medications are definitely not one of the affordable parts of the bill. It remains to be seen whether any parts of it will actually be affordable.
Tex
I've been afraid that was going to happen. I'm just guessing, but there's a good chance that it has something to do with the fact that major parts of The Health Care Reform Bill, aka "The Affordable Care Act" are finally being phased in over the next few months. The details remain hidden of course, but it appears that the insurance companies and pharmaceutical companies may have been pretty much granted a license to steal, under certain terms of the bill, in order to obtain their support for other parts of the bill. Medications are definitely not one of the affordable parts of the bill. It remains to be seen whether any parts of it will actually be affordable.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Entocort
My insurance will only pay for 30 days at a time.
It finally does seem to be working. I went a bit bonkers after 5 plus years and indulged in ice cream with hot fudge and a salad for dinner last night.
I have had some foot/toes and leg cramping.
It finally does seem to be working. I went a bit bonkers after 5 plus years and indulged in ice cream with hot fudge and a salad for dinner last night.
I have had some foot/toes and leg cramping.
DISCLAIMER: I am not a doctor and don't play one on TV.
LDN July 18, 2014
Joan
LDN July 18, 2014
Joan
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Tex,
It didn't dawn on me that the increase could be related to the Affordable(!) Care Act. I expected to find doctors less willing to take Medicare patients after its passage, but didn't think about the impact on prescriptions. I think everyone needs to check the formulary cost for their prescriptions next year. We are in for some shocking increases in price.
Joan,
I'm glad that Entocort is finally kicking in for you. A hot fudge sundae and a salad sound delicious. Maybe we can substitute a carmel-topped sundae using non-dairy ice cream. Tempting...
Christina,
Yes, I'll probably be ordering budesonide from either Canada or AllDayChemist, depending on whether my GI will write a script for me.
Gloria
It didn't dawn on me that the increase could be related to the Affordable(!) Care Act. I expected to find doctors less willing to take Medicare patients after its passage, but didn't think about the impact on prescriptions. I think everyone needs to check the formulary cost for their prescriptions next year. We are in for some shocking increases in price.
Joan,
I'm glad that Entocort is finally kicking in for you. A hot fudge sundae and a salad sound delicious. Maybe we can substitute a carmel-topped sundae using non-dairy ice cream. Tempting...
Christina,
Yes, I'll probably be ordering budesonide from either Canada or AllDayChemist, depending on whether my GI will write a script for me.
Gloria
You never know what you can do until you have to do it.
I'm afraid to check mine. I don't want to ruin my current good mood, so I've been putting that off as long as I can — either until the last minute, or until I'm already in a bad mood anyway.Gloria wrote:I think everyone needs to check the formulary cost for their prescriptions next year. We are in for some shocking increases in price.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Many of my meds have, and are coming down because of the AFA.
My neighbor, who has a 13 ear old son, got a rebate for the money she had spent over 80% from her insurance company.
My next door neighbor has a daughter in college who continues on her mother's insurance till she is 26.
So far all signs re: AFA are POSITIVE where I live.
My neighbor, who has a 13 ear old son, got a rebate for the money she had spent over 80% from her insurance company.
My next door neighbor has a daughter in college who continues on her mother's insurance till she is 26.
So far all signs re: AFA are POSITIVE where I live.
I just got my 2014 information for my Part D Prescription Drug Plan. I was very annoyed to see that the premium has increased a whopping 65%! And the copays on the drugs I take have gone up significantly too, by a combination of moving a drug to a higher tier with higher copays and increasing the copays of all the tiers from last year.
The medicare.gov website will have all of the information for the drug plans available in early October since the Annual Enrollment Period to switch plans starts Oct 15 and goes until Dec 7. I'm a trained Medicare SHIP counselor and work with clients to review their drug plans and make sure they get the best one for next year. All the states have SHIP counsellors if you need help with this. Anyone on Medicare should take a close look at their current plan and make sure there aren't any drastic changes in their coverage. Also,aAnyone can use the medicare.gov website to evaluate the plans based on the drugs you take. And many pharmacies will access the medicare web site with their customer's list of drugs and give them the names of the best drug plans for the following year.
I see first hand the difficulties many people have in paying for their drugs due to the rapacious pricing by drug companies. But the legislators seem to be in their pockets, so it's hard to see any chance of improvement in the near future. It's outageous what we in the US pay for drugs compared to the rest of the world.
Rosie
The medicare.gov website will have all of the information for the drug plans available in early October since the Annual Enrollment Period to switch plans starts Oct 15 and goes until Dec 7. I'm a trained Medicare SHIP counselor and work with clients to review their drug plans and make sure they get the best one for next year. All the states have SHIP counsellors if you need help with this. Anyone on Medicare should take a close look at their current plan and make sure there aren't any drastic changes in their coverage. Also,aAnyone can use the medicare.gov website to evaluate the plans based on the drugs you take. And many pharmacies will access the medicare web site with their customer's list of drugs and give them the names of the best drug plans for the following year.
I see first hand the difficulties many people have in paying for their drugs due to the rapacious pricing by drug companies. But the legislators seem to be in their pockets, so it's hard to see any chance of improvement in the near future. It's outageous what we in the US pay for drugs compared to the rest of the world.
Rosie
Our greatest weakness lies in giving up. The most certain way to succeed is always to try just one more time………Thomas Edison
That's because the rest of us are paying for it. There are no free lunches — someone always has to pay for them, plus having to pay for the government's cut, to boot.Lesley wrote:So far all signs re: AFA are POSITIVE where I live.
That's for sure. I just hope that Medicare will actually have the information (actual pricing) available on schedule this year. The way things are going right now, that may be a stretch.Rosie wrote:But the legislators seem to be in their pockets, so it's hard to see any chance of improvement in the near future. It's outageous what we in the US pay for drugs compared to the rest of the world.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.