Posted on 11/26/2021 7:23:44 PM PST by SoCalTeresa
I have been fortunate to have great health most of my life with no prescriptions. I now have a prescription for a thyroid problem for the past few years and has never been a problem getting filled. Not life threatening. I have Medicare Part A and B, Wellcare Prescription coverage, private insurance through my employer and am told that my $13 a month prescription can't be renewed because it is being reviewed. I pay close to $5,000 a year for medical insurance. Is this normal?
The brand I was using was "under review". Got my doctor to prescribe another brand and everything went back to normal.
You probably already know this but be very careful with generic thyroid medicines. They only have to be 80% as effective and as your doctor can tell you that much change in a thyroid medicine can cause trouble.
What is your prescription for?
Yes.
This could be for a variety of reasons. They might be investigating why the doctor would prescribe those meds for your condition. This is not necessarily a bad thing.
I just pay cash for my thyroid medication it is cheap!!
I’m 63 and I pay almost $1,600 per month for health insurance thanks to the “Affordable Care Act”.
Yeah, it is.
Between me and my doctor.
None of their business.
Medicare is my primary provider, but I have my Medicare-approved prescription coverage through New York State’s Empire Plan, my secondary provider. I retired from State service in 2003. I have had regular scripts for a generic muscle relaxer (Metaxalone) for several years now. Up until this past year, there wasn’t an issue with them. My prescription provider is CVS Caremark. That is the pharmacy connected to my plan For some reason, the last script that was written for me had to be reviewed, and an authorization was issued for 6 months. I don’t take the medication that often, but I like to have it on hand, just in case I get a muscle spasm in my lower back. I had one refill on the script, but when I reordered it, I was told the 6 month authorization had expired, and they wouldn’t fill it. It didn’t matter that the script that included the second refill was written and authorized for that 6 month period. Because I hadn’t ordered the refill within that six months, it voided the second refill. I had to recontact the doctor’s office, and ask them to contact CVS Caremark in order to get another 6 month authorization. I’ve only had prescription coverage through New York State, starting when I first went to work for them in 1980.
Thank you. I have Medicare and private insurance. The issue isn’t the $13 the medication costs. The question is why it is being “reviewed.” It has been 10 days since this prescription has been under review, although it has been prescribed for three years with no problems. I pay about $5,000 in insurance premiums each year. Why is this now a problem over a $13 prescription? This is outrageous. I will call Mnnday.
Not saying it's wrong - it's just that we're about to go through the Medicare door and attempting to understand it better.
Part A makes sense, because there's not cost.
“between me and my doctor”
I work in health insurance. Those doctor/client reviews of treatment by insurance companies have saved a significant amount of money and lives and saved people from harmful treatment by a Huge measure
Doctors mess up daily
Also doctors get bonus/trips my drug companies if they write so many prescriptions
Many a doc will write you a 100 month ex when a 5 generic works just as good, maybe better but they want that bonus check
If you dropped employer coverage, you could get a supplement and spend about $300 per month total
If you work full time, not sure is you can do it. Employer had to cover you. Maybe
Possibly to avoid future jack penalty (delayed enrollment). Can’t see it either unless the private insurance may go down.
My health care almost tripled under “Affordable Care Act”.
I’m a few years older than you and I’m paying just a bit more than half you are with BC/BS. But went from $250 to $720 under Obama.
Thank you Bammy. (Jerk)
But check out alternatives.
Depending on your specific thyroid problem, you might clear it up with selenium and iodine supplementation.
My wife and I pay $2000 per month with a 8750 deductible each. No rx is covered until deductible is met. We are late 50’s. My wife was sick 2 years ago and one of her prescriptions was 425 month. So we were paying almost $2425 per month.
Govt employees and seniors have no idea how much they have the gravy train
I wish they would drop the medicate age down to 60
I paid for Medicare Part B because at the time I was not covered by private insurance. Since then, I obtained private insurance through my employer who I hope to work for the next 7 years. Whether that happens is not certain, but my best guess is that it will be based on my industry and the economy. As I understand, if I cancel Part B and my Prescription drug coverage, I will pay a penalty. I am not upset with the insurance I pay, although it is a lot, but why a $13 prescription is under review
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