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Venting because only DL snark will snap me the hell out of it

I just spent the last week jumping through hoops and red tape with my insurance about what they won't and will cover regarding prescriptions.

We've gone back and forth. My doctor's office has gone back and forth on the "medical necessity" of the dosage for medication for high blood pressure. I've had to call my doctor's office daily.

The co-pay for my blood pressure medication is $45 for a 3 month supply. As of Jan 2, they are only willing to cover half the dosage for the same period (90 pills instead of twice daily 180 pills)

I just checked the prices. If I use a discount place like GoodRx, I can get a 3-month supply at my full regular dosage for $70. Seriously? My insurance company, who would have to pay if I had a stroke or heart attack from high blood pressure, won't pay for what amounts to $25 per refill or $100 total for an entire year.

I can't decide which is worse - the insurance company's idiocy at not paying vs. the fact I wasted a lot of time and effort, not to mention the extreme stress because I'm out of medication and cannot get a refill, all over $25.

by Anonymousreply 11February 10, 2024 10:52 PM

I'm confused. Is your blood pressure med $45 for a 3 month supply, or $25?

by Anonymousreply 1February 10, 2024 2:47 AM

[quote]I'm confused. Is your blood pressure med $45 for a 3 month supply, or $25?

The 3-month supply with the co-pay was $45. However, they've changed the dosage that they're willing to cover from 2 pills a day to 1 pill a day (half the dosage).

I can pay $70 cash and get my regular dosage (2 pills a day) of the same medication without bothering with my insurance - difference of $25 dollars. It's standard ARB and calcium channel blockers, not some exotic new medication or even particularly specialty drug - it's generic, not even name brand, blood pressure medication that millions of people take daily.

by Anonymousreply 2February 10, 2024 2:54 AM

Just have the doc write a scrip for the higher dose in a single daily pill. What’s the issue?

by Anonymousreply 3February 10, 2024 3:06 AM

Is there some reason in your mind why you won't state the name of the medication?

by Anonymousreply 4February 10, 2024 3:06 AM

My insurance company stopped covering a couple of generic meds I take. One would have cost me $600 for a three-month supply if I filled it through the mail order service. I went to Good Rx and got it for $25 for a 90-day supply.

It's all a scam by insurance companies and pharmaceutical companies.

by Anonymousreply 5February 10, 2024 3:11 AM

Teach those jerks a lesson. Get off the pills!

Offsite Link
by Anonymousreply 6February 10, 2024 3:21 AM

OP , what type of med ins do you have?

Medicare, Obamacare? Work related insurance?

by Anonymousreply 7February 10, 2024 3:26 AM

Maybe they will cover a different brand?

by Anonymousreply 8February 10, 2024 3:46 AM

I pay $75 copay for a 3-month supply of short-acting insulin. $75 for a 3 month supply of syringes, ditto for test strips.

by Anonymousreply 9February 10, 2024 4:36 AM

[quote]OP , what type of med ins do you have?

I have some crappy insurance that I got on an exchange - which still costs $850 per month.

HUGE mistake.

by Anonymousreply 10February 10, 2024 10:13 PM

OMG, OP you are one of those really rich people that fall under higher premium Obamacare.

If you make over $100k a year and got hit with the higher premium, then we uit your rich ass bitching and march with us for universal healthcare. And then you can get private platinum insurance on to if that.

by Anonymousreply 11February 10, 2024 10:52 PM
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