Re: rx med cost - Jill

April 16, 2008

Hi Jill,

Forgive me for butting in, but I used to work in health insurance and

may be able to help you suss out your current benefits. It sounds

like your health insurance has a drug formulary. It may also be that

your pharmacy benefits are a tiered plan, with different drugs

costing different copays. The easiest way to confirm whether or not

you have a tiered drug plan is to look at your health insurance card.

Almost always (I've never seen one that doesn't have it) the pharmacy

cost to the member is printed right on the card. If you have a two-

tier drug benefit, there will be two different prices listed. If it's

three-tier, there's three, and so on. You can also call your

insurance company's customer service to get the drug benefit

information. Now, if you see those different prices on your card for

your drug benefits classes, you will know you have a tiered drug plan

(might say drug class or something similar). Once you know that, you

can look at the formulary listing. Most large insurance companies

have a website. I would check to see if yours has one. If so, create

yourself a member account, if that's an option, to see your benefits.

Find the drug benefits and look at the entire listing. Read the

information about which drugs cost which price. Next, print a copy if

you have a printer, of the entire formulary listing. If not possible,

ask customer service to send you a copy. Hand carry that with you to

all doctor appointments. When the doc hands you a prescription, ask

the doc if there's an appropriate drug that's cheaper, based on that

formulary printout. In fact, what I do when health insurance changes

is take the whole blessed thing plus all my meds to the doc and go

over the drugs with the doc. You'd be surprised how much money you

may be able to save. For instance, there are low-cost generic meds

under various store plans, Kmart, WalMart, etc, that have their own

generic list of $4 or $5 generic drugs. Those listings are also

generally available online. I take those printouts with me too, when

I go to the doctor. At this time I've been able to get all but three

of my regular drugs down to one of these $4 or $5 copays per month.

The others I simply have to pay for.

If you need any more info, just give a holler. Good luck!

girlsaylor

>

> My husband started a new job last year and we were given the worst

insurance I've EVER heard of. They changed it shortly after he

started or I don't think he would have taken the job. I have been

beating my head against the wall because he HAS NOT changed

jobs.....he hates change. But he also hates being broke and we are

so stressed out, I don't get why it wouldn't be less stressful to

change jobs. Luckily, we are moving back to Phoenix in June so he

will have to find a new job. So, are you guys ready to hear what our

> MONTHLY RX BILL IS........................................

> $1,500 to $1,600 HELP ME!!!!!!!!!!! I think I'm having a

nervous breakdown as I write this.....breathe.....That doesn't

include co-pays for dr. visits....and some they won't cover at all.

I can't figure out how the differentiate and it's killing us! The

tension in this house gets crazy sometimes.

> Jill

April 17, 2008

Thanks for all the info! I do always try for the generic brands. I have tried

to figure out what is all involved with this insurance, but keep getting a

different story. There's really nothing we can do about it since no private

insurance will accept my son or me. And we're moving so......we just need to

get thru this until my DH's new job's insurance kicks in. But, even the last

couple of years before I was treating my fibro/cfs so aggressively and had

better insurance, my rx bill was always around $1000/mo (that's for the twins,

too).