POZ Community Forums
Meds, Mind, Body & Benefits => Insurance, Benefits Programs & HIV => Topic started by: Turtle-12 on February 18, 2014, 09:47:40 pm
-
Hi all, I would like to know if anyone out there knows the price of Tivicay and Truvada (my current combo). I am currently looking for alternative ways of getting my meds, as my insurance can only fill my prescription in a monthly basis and i would like to have some meds on the side for eventualities (just in case)... Also, where to get them without a hassle in Southern CA would be good...thanks
-
Depending on your income, you might qualify for help in the price. I am on Truvada and Intellence. I cannot remember which one it was, but a 3 month supply for both was a little over $5,000.
I go thru my online pharmacy for a 90 day supply - and they charge $180. I am on a plan that pays the co-pays for one and the other is $15.00.
I am surprised the insurance does not allow a 90-day supply.
But this is what I do for my partner who takes Aceon for high blood pressure. Aceon went generic and when he took it, I had to take him to the ER. Cigna had a 3 tiered system for this drug. After a $15,000 ER visit, Cigna required him to take another from Tier 1 and one from Tier 2 before the brand name would be approved. So I thought I would just get the doctor to right a RX for both of these and then have him say it did not work. But Cigna required documentation - basically ER visits.
I went around them a few times and finally got Aceon approved on a 30 day basis. So what we do is, you can usually call in your RX 6 or 7 days before. We go to the pharmacy at the hospital because he is the only one that can get it. It is not worth it for the major pharmacies.
But with this system of calling, he has almost 3 months supply on hand. I would recommend using a small pharmacy and get to know him / her. Don't go to a chain or grocery store. You will learn more from a small, local pharmacist.
Hope this helps some.
-
i think all antivirals are considered SPECIALTY DRUGS ,so we are forced to use mail order specialty pharmacy,at least thats what CVS thru UNITED HEALTH CARE IS DOING.I USE TO GET ALL MY MEDS AT A LOCAL PHARMACY THAT WAS FUNDED THRU RYAN WHITE BUT THAT HAS CHANGED AS OF JAN.1 2014
-
i think all antivirals are considered SPECIALTY DRUGS ,so we are forced to use mail order specialty pharmacy,at least thats what CVS thru UNITED HEALTH CARE IS DOING.I USE TO GET ALL MY MEDS AT A LOCAL PHARMACY THAT WAS FUNDED THRU RYAN WHITE BUT THAT HAS CHANGED AS OF JAN.1 2014
Armando - as you infer, it is very plan/insurance company specific and drug specific whether it is classified as a "specialty drug" or not. Stribild for instance for me on my plan is a Tier 3 drug (non-preferred brand name), while Truvada is a Tier 2 drug (preferred brand name). There is also a Tier 4 classification in my Drug Formularies which is "specialty drug". Very few HIV related drugs are considered 4's, where many are 1's and 2's. If a drug is not specifically listed they automatically are assigned into Tier 3, which I find reasonable and better than them automatically putting a new drug like Stribild into Tier 4.
But again it is very plan specific and you have to get the drug formularies to figure this stuff out.