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Re: Retirement and Xolair

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Doug:  We have medicare and the insurance my husband had when he retired from

the government.  I get all of my drugs through my husband's insurance, and I've

been told that it is equal to or better than any of the drug prescription

programs for those on medicare.  So we did not get the medicare prescription

insurance.  I pay nothing for my xolair shot.  Part of that is because I go to

a research allergy clinic for my xolair (at least that is what I think.)  If I

had gone to my allergist for xolair, I would be paying over $300 a month and

that would be too much for us to have to pay with the other meds I still have to

take.  Just thought I would share that with you.  However, in 9 years, a lot

could change.  And I do not know yet what the changes in the new law will mean

for my coverage.  So far, nothing has changed.

 

Have a great day.  It is warm and sunny here, but we have very cold weather on

the way!

 

Adah

From: Db <uca79iii@...>

Subject: [ ] Retirement and Xolair

Date: Sunday, January 30, 2011, 6:44 AM

 

I have Highmark BCBS who uses Medco for my prescriptions and I am on my wife's

policy where she works which I use as a secondary .. Health Advantage BCBS who

uses Caremark for their prescriptions.

I go to the pharmacy and get a months supply and medco pays all but the co

payment. I send the receipts by mail to caremark and then they reimburse me. I

have been approved for xolair by both insurances however, Medco only lets me

order xolair in a 3 month supply and caremark will only accept a one month

supply and does not like the way medco writes their receipts. Therefore, I do

NOT get reimbursed by caremark.

Here I am covered by TWO companies and one will not pay because of the way the

other does business. My co pay through Medco is 150.00 every 3 months and my

xolair mastercard by genetech/norvatis pays 120.00 of it. My co pay is only

10.00 a month.

I AM worried about when I turn 65 in 9 years. I will have medicare and my

primary insurance will turn into a supplement. I will have to buy medicare part

D to get prescription coverage.

If I can't get xolair, then I will be put BACK on pred and then the side effects

will shorten my life. Oh, I had PLENTY when I was on 40 mg a day for YEARS! I

will not go into detail because of space LOL!

I hope by then there will be an easier way in 9 years. I hear that Medicare will

run out by then.

Doug

Group founder

on Xolair since 2003

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Doug -

You might have your wife contact her Human Resources department regarding

Caremark's refusal to provide reimbursement for the amount that you pay to

Medco for your Xolair. Group representatives can often get further on these

issues than the individuals who are covered under their plans.

Kendra

On Sun, Jan 30, 2011 at 6:44 AM, Db <uca79iii@...> wrote:

>

>

>

> I have Highmark BCBS who uses Medco for my prescriptions and I am on my

> wife's policy where she works which I use as a secondary .. Health Advantage

> BCBS who uses Caremark for their prescriptions.

>

> I go to the pharmacy and get a months supply and medco pays all but the co

> payment. I send the receipts by mail to caremark and then they reimburse me.

> I have been approved for xolair by both insurances however, Medco only lets

> me order xolair in a 3 month supply and caremark will only accept a one

> month supply and does not like the way medco writes their receipts.

> Therefore, I do NOT get reimbursed by caremark.

>

> Here I am covered by TWO companies and one will not pay because of the way

> the other does business. My co pay through Medco is 150.00 every 3 months

> and my xolair mastercard by genetech/norvatis pays 120.00 of it. My co pay

> is only 10.00 a month.

>

> I AM worried about when I turn 65 in 9 years. I will have medicare and my

> primary insurance will turn into a supplement. I will have to buy medicare

> part D to get prescription coverage.

>

> If I can't get xolair, then I will be put BACK on pred and then the side

> effects will shorten my life. Oh, I had PLENTY when I was on 40 mg a day for

> YEARS! I will not go into detail because of space LOL!

>

> I hope by then there will be an easier way in 9 years. I hear that Medicare

> will run out by then.

>

> Doug

> Group founder

> on Xolair since 2003

>

>

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--- In , Kendra Tiedemann <kendra.tiedemann@...>

wrote:

>

> Doug -

>

> You might have your wife contact her Human Resources department regarding

> Caremark's refusal to provide reimbursement for the amount that you pay to

> Medco for your Xolair. Group representatives can often get further on these

> issues than the individuals who are covered under their plans.

>

> Kendra

>

Kendra,

Thanks but I don't mind paying 10.00 a month when they pay everything else. I am

on quite a few prescription drugs for things other than asthma too. Now, if I

ever have to take another specialty drug then I might need to take your advice.

thanks again,

Doug

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