Irritable Bowel Syndrome and Digestive Health Support Forum banner
1 - 7 of 7 Posts

·
Registered
Joined
·
559 Posts
Discussion Starter · #1 ·
I was wondering what everyone is paying for this new drug, the type of insurance you have, especially if you don't have insurance, and also the co-pay.I have CTcare, and it does NOT pay for it, in a way which I don't understand. I called and asked them, they said we don't pay anything on that paticular medication, but we do pay some. That makes no sense to me at all. Either they pay or they don't. I did some thinking......I came up with this. Since they don't pay for it, and the pharmacist said it would cost $80.00 without insurance, I pay a "co-pay" of $40.oo, so does this mean that the insurance co. pays nothing at all, after all, that's the way they put it. Could be that's what it costs the pharmacy, with a little more added on for their part in making a few bucks.I also feel for those who don't have insurance......the insurance companies do not pay full price, and the person with insurance pays a co-pay, which more then likely covers most of the drug. No if one doesn't have insurance, they have to pay "full" price. This is, no way, fair. Now, understand, this is only on the new meds that are just coming out. I do have co-pays of $7.00, $10.00, and $15.00. I take Zomig for my migraines, (it works wonders for me) I pay $15.00 for it. I am only allowed 9 pills each 30 days. So that means my insurance co. only pays for 4 and a half migraines. I get them just about every other day. I have to dish out $198.00 for 9 pills. Don't get me wrong, it's well worth it, when I am having a migraine, but after it's gone, I freak out.
 

·
Registered
Joined
·
85 Posts
WEll, I am on BlueCross insurance and they have yet to cover Zelnorm although I have letters into them from the GI and my primary dr. to show how I've tried stuff but thsi works to try and get them to cover it for me, but right now I am paying $153 for a months worth..and I hate that, its too much especially when if covered I would pay $11, but hey I will pay it in hopes that soemday it will be covered, and because it works for me so its worth it
 

·
Registered
Joined
·
17 Posts
I'm with Aetna and my prescription plan covers it in their formulary. I just paid a $20.00 copay for 60 tablets. And don't think I'm not grateful, this is one pricey med!!
 

·
Registered
Joined
·
559 Posts
Discussion Starter · #4 ·
I know it's honest, but I was thinking of asking my Doctor to write out the script for 3-4 per day instead of 1-2 a day. The insurance company is making money off of me, for what I have monthly for insurance, then the CO-pays, and it went up this year, the insurance premium another $20+ dollars. I just think it's not fair. They make enough money off of me. Our of my paycheck when I was working, nearly a third and sometimes almost the whole paycheck went for CO pays. Like I said I was only thinking of doing this, but more than like won't, because of my honesty. This just ticks me off. I have to pay $40.00 for the Z, and also other meds I am on. It adds up. Maybe with what I had left over from my pay check, I should have invested in my insurance company. Also, I am one of those people, who start off with a brand name, and when a generic comes out, I refuse to get it. Now, on the other hand, if there was a generic, I would have gotten it.Jadair
 

·
Registered
Joined
·
559 Posts
Discussion Starter · #5 ·
I wonder how they determine the price of these new medications. The time they put into it is the only possible one I can think of. Forget what they put into it, it probably cost pennies. Could be sugar and salt for all we know. It'd be nice to know what exactly is in all of these medications. Does anyone have a site where this information could be found?
 

·
Registered
Joined
·
2,427 Posts
Jadair, I found a doctor that gets migraines himself and he allows me all the medication I want. I use Imitrex mostly. I use it sparingly. I use to keep the Excedrin people in business but that is so hard on my stomach. Some one on the migraine BB suggested that you get the Imitrex in the 100gm. tabs instead of the 50gm and then use half of one at a time so you might check and see if Zomig would work that way too. I use the injections myself, and found the Zomig didn't help much. I have used Maxalt also,but it is not as effective as Imitrex.I started taking Primal Defense{/b], a probiotic and it has seemed to help lessen the magnitude of the migraines I get. Maybe it is cause I don't eat anything after supper so that I can take it on an empty stomach before I go to bed. Who knows but it seems to work.IT is expensieve but I found a place on line that I could get it for about 2/3 the price of the health food store I went to. http://www.iherb.com/primaldefense.html I was using it for a gas and odor problem that it was suppose to help but so far it hasn't done a thing for that.
 

·
Registered
Joined
·
559 Posts
Discussion Starter · #7 ·
Hi Joyce,Got your message. I decided to take a break from the BB's for a while. I certainly missed you all. It seems like I'm back home again. It's like a home away from home, if that makes sense to you.As far as the Imitrix, I do have 6 pills, that's all my insurance covers a month. I had refills on them, and went to pick them up, the price was outrageous. I said, I do have insurance, why did it not cover it. After the long waiting, it boiled down to where my Doctor had to prove to my insurance company that it was medically deemed necessary. I didn't bother going through the trouble at that time, because it is such a hassle. Just what the insurance companies love, and know most people will do. I am waiting on another medication to go through now, for two weeks. Seems no one knows nothing. Back to the Imitrix...I haven't had the chance to take them yet. With a new medication such as this one, and especially for a migraine, I'd like to take it the first time when I am home, and I have not had a migraine at home since.The Zomig work wonders for me. At the first sign...the eyes getting blurry and spots, and well, you know the story line, I take a Zomig. Two hours later, I take one more if I still have symptoms. Does that two hours go by fast. Most of the time I take it cause I have that lingering headache, and it takes it away, and I am fine. It was my idea to ask my Doctor for the Imitrix. Not that I want a Migraine, but I hope the next one comes when I am home, so I can take them. I take the highest dose in the Zomig. I don't have them here with me right now, and I have quite a few medications, I really don't remember the mg of the Zomig. I believe that they are 5mg. I have both, the tablets, and the meltables. I have so many samples of the Zomig, and so happy I don't have the co-pay, which is either $15.00, or $30.00. I haven't had to go to the pharmacy for them lately, but I believe the Imitrix was more, and the Zomig was less. Now that I think of it, they both could have been $30.00. With the Zoming, my insurance co. only allows 9 pills a month, that's 4 and a half migraines a month, that I am allowed to have, according to them. I call Zomig, my wonder medication. I tell people I'd rather have a migraine, than a "regular" headache, because the Zomig works so well.I think I blabbed enough for now, talk more later.Jadair
 
1 - 7 of 7 Posts
Top