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Diabetic Connect Member BAJC

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Brand Name Co-Payments

by BAJC
May 8, 2009 1:50 AM
16 Replies
261 Views

I was dismayed to see that my insurance coverage is raising the co-payment for brand name drugs from $60 to $80 for a 90-day supply. I understand trying to nudge people towards generics, but there is no generic for my insulin or my test strips.

Tags: copayments, insurance, supplies, generic meds, brand name meds

From Replies
Diabetic Connect Member Deleted User
Deleted User
Deleted User replied May 8, 2009 1:53 AM 

Sad to say, insurance companies don't give a rusty rats bottom if they suck our wallets dry. I wish I could turn it back onto them, see how bad they buck about it.
Diabetic Connect Member cyncyn
cyncyn
cyncyn replied May 8, 2009 2:18 AM 

The insurance companies are "legal thieves". They rob many of thousands of people a day, and get away with it! I bet they don't have to pay the prices, that we do!!!! Our insurance company won't pay for brand names. If it's not generic, then you pay full price, out of pocket! Kinda, makes you wonder, why do I even carry it!!!! Somebody needs to put a cap on this!!!
Diabetic Connect Member Judimar
Judimar
Judimar replied May 8, 2009 4:24 AM 

Last edited 6 months ago

My old insurance raised both name brand and generics. I haven't used the new insurance yet but will soon. I agree with you though.

Diabetic Connect Member kdroberts
kdroberts
kdroberts replied May 8, 2009 2:25 PM 

Well, it's for another discussion but you have to look at the evolution of health insurance and what it was really intended for.

However, you have a pretty low copay when compared with others. My co-pay used to be $90 for 90 days brand via the insurance company, then that changed to 30% with a minimum of $90.. Right now I pay $70 for a 30 day supply of one drug and $55 per box of insulin pens. You should make sure that you are being charged right for your insulin and testing supplies because often if a generic is not available for an entire class, like insulin and testing supplies, you will be charged the generic co-pay even though what you are getting is technically brand name. Because of this I pay 20% for testing supplies and insulin rather than 30%. That saves me about $20 per box of insulin pens and $10 per 100 test strips. Every little helps.

BAJC replied May 9, 2009 8:01 PM 

Thanks for your thoughts. I never thought I was worse off than everyone else, i just wanted to vent.
I do understand the evolution of insurance. I worked in health insurance administration for 14 years (starting way back in 1989.)
Diabetic Connect Member John Crowley
John Crowley
John Crowley replied May 8, 2009 2:33 PM 

I've actually found that my insurance company can be pretty helpful if I call up and talk through all my options for getting my supplies at the lowest possible cost. I have to get some stuff through the pharmacy and some stuff through a DME (which at times can be a pain) but it's worth it to me to save substantial amounts of money on our diabetes supplies.

Now, having said all that, yes, I have been amazed at how much more we pay now than we did when my son was diagnosed just 8 1/2 years ago. The cost to produce the supplies certainly couldn't have risen nearly as much as my co-pays have.
Diabetic Connect Member Sarguillo
Sarguillo
Sarguillo replied May 8, 2009 5:41 PM 

I agree with John, Call them up and ask if they have certain supply sites they work with. I know if I order through my hospital pharmacy, I get a lower co-pay then if I go to an outside pharmacy. Good luck.
Diabetic Connect Member mamaoak
mamaoak
mamaoak replied May 9, 2009 1:18 AM 

some supplies you can get and order on line it is alot cheeper i get my test strips they were 25 dollars for three month supply. my husband gets his blod presuer pills as well.

Diabetic Connect Member king of hill
king of hill
king of hill replied June 1, 2009 7:28 PM 

Last edited 5 months ago

Hello. I get my supplies through a medical supplier christian healthcare. They are able to get me the supplies throughmy insurance from work without a copay. I receive a 90 day supply of test strips, pump supplies and insulin. I have become friends with a man who works there. His names John his # is 888 777 0737 extension 2024. I have no complaints been using them for years.

-Mathew Hill
Diabetic Connect Member Gabby
Gabby
Gabby replied June 2, 2009 12:41 PM 

Just wait until we end up on government health care...it will be more price fixing and selective coverage. It will be insane to be sure. I don't have insurance, and now, if it is not a generic, I can't afford it. So I find other ways around it. I realize being type 2, I can bend around that. Unfortunately, more and more, it is going to be hard to support our needs in the medical realm.

Judimar replied June 2, 2009 5:31 PM 

AMEN!

Sarguillo replied June 2, 2009 6:24 PM 

One thing I predict if we do get national health care is that the care will dumb down for those with high levels of care, but it will also be made available for those who have almost no level of care. It will average out.

Gabby replied June 2, 2009 10:27 PM 

Unfortunately, it never works out that way. That is Socialism and eventually it means everyone will have the same crappy care in the end. So even if you want and can afford good care you are stuck with junk. The middle class will be gone. Only the insiders of government elite will have the good stuff. The rest of us will suffer greatly.

Fortunately, there are a couple of bills just proposed this week that will allow doctors to choose what is best and won't penalize us if we choose not to use the National health care. They are HR2630 and HR2629.

Judimar replied June 2, 2009 11:20 PM 

Thanks for sharing that Gabby. I hate to see what you're prediciting coming true, but I fear you're right.

Gabby replied June 3, 2009 12:25 PM 

I try not to get into my political brain on here too much. Not the right format. But health care, or the lack of it, is one of my political passions and I fear that we believe the media too much.

I hear flowers being spewed from this admininstration's mouth, while it is really just...shall I say, fertilizer. I try to keep an eye on Congress and read the bills that they are working on (even if they don't read them). I write to my representatives and encourage co-sponsorship of certain bills and to vote NO on others. It doesn't always pan out the way I hope, but at least I am involved.

If we as diabetics really want to make a difference, get involved. Read the bills they are passing, don't just depend on what the media says they are doing. It will really frighten you when you see the garbage that gets put into law up there without a peep from us. We really have no clue what is REALLY going on up there.

If you want to find out where to locate bills, write to all your representatives and more, just drop me a note. I will be glad to share and help you get started.

Vicrgreen replied August 21, 2009 6:50 AM 

I posted a link under the Insurance heading to a copy of the HR3200 Health Reform Act Bill, known as ObamaCare. It is the actual Bill itself, not someone's version of the Bill. When you read it you will know exactly what is proposed. I got tired of all the he said, no he said stuff and decided to read it for myself.

At this site as you go through the bill there is the option to make comments and read the comments that others have made at most breaks, after each section and subsection.

I'll tell you what, it is scary. Go read it for yourself.