Atripla Co-Pay Increase for Humana Insurance in 2009

[Lou-ah-vull]

My employer-based health insurance is with Humana.  I received a letter yesterday advising me that my Atripla was being placed in a higher "level" effective January 1, 2009.  Currently, Humana insured persons pay a co-payment of $30 for a thirty day supply of Atripla.  This is the second tier of Humana's four tier system.  The letter did not specify whether Atripla was moving to the third or the fourth tier.  Furthermore, this information was not findable on the website.  This afternoon, I telephoned Humana Customer service and learned that Atripla will be a "third" tier drug next year...meaning a $55 copayment for a thirty day supply.  While this is a hefty increase, I am at least relieved that Atripla was not placed in the "fourth" tier.  This tier requires a 25% copayment with an out-of-pocket ceiling of $2500.  Of course, this could happen in 2010.  Until I made the phone call I experienced some stress worrying about this potential new cost.

I am curious if anyone else has received information that HAART drugs will be re-evaluated by their insurance companies in 2009.   I also never forget how fortunate I am to have employer-based health insurance with prescription drug coverage.  I am aware that drug costs cause significant stress for many of those who post here. 

I decided to post this because there may be other Humana insured on this site and they may not know about this.  I continue to hope that our political leaders will find a way to give everyone the dignity of adequate health care rather than reserving it for the privileged or lucky few.

Gary

[David_CA]

Gary, maybe we should call them 'in-Humana' instead.  I sure hope they chill.  singling out a particular class of drugs for increases is wrong.  Although there are a lot of us on HAART, we are still a vast minority.

David

[skeebo1969]

  Damn this is really bad news.  My wife and I have Blue Cross Blue Shield and our compays are $60 per HIV script.  We both take 3 different scripts so it gets pretty costly.   We use a mail order pharmacy which allows us to get a 3 month supply at the one month co-pay rate which helps keep the cost down.  Does your insurance allow this?  If so are you using such? 

  It is very convenient.  The pharmacy we use even gives us a call 2 weeks before we are due to run out to remind us to refill.  If you would like the info just PM me...

 

[Lou-ah-vull]

Humana has a mail order option where I can get a 90 day supply for the price of only two co-pays.  Up to now, I have been reluctant to use it because I have such a good relationship with my local Walgreen's pharmacy.  I always worry about a late delivery or a package left abandoned on my front porch with the mail order option.  However, I am aware that many people have had excellent and dependable results with mail order.  I will give it some thought. 

Gary

[J.R.E.]

My employer-based health insurance is with Humana.  I received a letter yesterday advising me that my Atripla was being placed in a higher "level" effective January 1, 2009.  Currently, Humana insured persons pay a co-payment of $30 for a thirty day supply of Atripla.  this potential new cost.

Gary

This doesn't surprise me Gary. I am also covered by Humana HMO, through my group insurance at work. All my co-pays ( for the HIV meds are$30.00 each. And of course, we're getting to that time of the year, where the company starts negotiating again. So far, haven't heard of any changes yet. I hate this time of the year, I really do !


I had heard, about insurance changing the tier /prices/co-pays, of some of the drugs. I will have to see, if I can find the story on this. I believe it was mentioned here a while back.

Ray

[J.R.E.]

Humana has a mail order option where I can get a 90 day supply for the price of only two co-pays.  Up to now, I have been reluctant to use it because I have such a good relationship with my local Walgreen's pharmacy. 
Gary

I also understand how you feel on that issue. I have alo been dealing with Walgreens for the past 5 years of getting my meds, and never had any real problems. Humana, is always asking me to purchase the meds through the 3 month plan. But I am very hesitant about it. Now I have the "Humana Nurse" calling me, once every two months or so, asking me to change. At this point, I really don't want to.

Ray

[SoSadTooBad]

Once you switch to mail order, you will never go back!  I have Blue Cross / Blue Shield and Express Scripts manages the pharmacy part of the program.  For one month's co-pay, I can order a three month supply, which is delivered in a few days.  The best part is that you can order another three months supply when you have a month left - so you can accumulate a very large supply of drugs in the event you need them.  I am sitting on a 6 month supply of Atripla, which makes me a lot less nervous about running out if I lose my job. 

[mecch]

The best part is that you can order another three months supply when you have a month left - so you can accumulate a very large supply of drugs in the event you need them.  I am sitting on a 6 month supply of Atripla, which makes me a lot less nervous about running out if I lose my job. 

I mentioned this strategy in another thread. I guess you have considered 2 year shelf life of the Atripla? So don't just keep the bottles in the cabinet indefinately. Use the oldest bottle and replace it with the newest, extra arrival. That way your store won't go out of date.

[Lou-ah-vull]

JRE-

I get those calls from the Humana nurse also.  We must be on the same list....lol.  Express Scripts manages the Humana program also.  It helps to learn that others here have had a good experience with Express Scripts.  Of course, our plan is two copays for three months supply...but that is still better than the retail pharmacy.

[texasguy]

I also have Express Scripts on my employer-based health plan.  I do mail order and get a 90 day supply of Atripla for $50.  I also order a month early and have built up a 4 month supply and intend on continuing doing that.  It's like having a little "drug savings account" in case a layoff or something really bad happened God forbid.  I love Walgreens though and get my generics and other supplies with them.  Here in the Dallas market their stores seem to have better selection and prices than the CVS stores.  It's ridiculous how many stores there are here.  There are 3 CVS and 3 Walgreens within 3 miles of my house!  I don't know how they make money that way, but I guess they do.

[Pippet]

My husband received the same letter from Humana.  He currently pays $40 for 30 days.  After some investigating, we couldn't find what the new price for his Atripla will be.  I was wondering if anyone has checked into the price of Sustiva and Truvada.  I pay only $20 each for a 30 day supply of Truvada and Kaletra. (My insurance is not Humana.)

Pip

Now playing on TV... a Humana commercial.  How ironic.

[Basquo]

I have Humana, but my scripts are through Caremark.  They let me get mailorder prices (3 month supply for $60) at Wal Mart, but supposedly they are adding CVS (my preferred pharmacy) to the roster next year. Most of my scripts are generic but one is not and that deal really helps me out. Otherwise I'd have to take a generic that gave me explosive diarrhea in the morning and a splitting headache in the afternoon.

[mikeyleerocks]

I use mail-order and get a three month supply for a one month price - I'm not sure how I'd survive otherwise ... very good deal and after the first order they seem to arrive in only a few days , so no fear of running out ... there's even been an option if you think the delivery date is too close to get the meds locally for a limited # of times

[NLEWLAD]

FUCK,  FUCK, FUCK!

i dont want to sound or be patronising  to any of you in the usa,  but seriously you need to start a pertition in the usa 

i live in england and am english,  here in the uk  our govenment pays for all health care including hiv medication

i wish there was something i could do to help you out.

you totally need and should fight for a NATIONAL HEALTH SERVICE dont get me wrong  in the uk every working person pays something called national insurance - 

NI  Payments which is taken out of our wage  pays for  healthcare and pension
 

i for one could not live with out the uk's  NHS    - NATIONAL HEALTH SERVICE

i know this does not help but i am shocked that you have to pay for health care, in the greatest country in the world  the us of a

[pozmnguy]

LOL The copay for my atripla is $730.00/mo with United Healthcare.  

Best of luck to all,

Jim

[edfu]

LOL The copay for my atripla is $730.00/mo with United Healthcare.  

That is totally outrageous.  Do you have a group or individual policy?  What is your monthly premium?

[Esquare]

Each year I pay $1000 out of pocket for my Atripla through BCBS.  It's better than no coverage I guess. 

[AndyArrow]

Humana has a mail order option where I can get a 90 day supply for the price of only two co-pays.  Up to now, I have been reluctant to use it because I have such a good relationship with my local Walgreen's pharmacy.  I always worry about a late delivery or a package left abandoned on my front porch with the mail order option.  However, I am aware that many people have had excellent and dependable results with mail order.  I will give it some thought. 

Gary

My situation is different in that I have Indiana Medicaid and not private insurance but I am able to get 3 month supply of all my medication at Walgreens.  The Walgreen's I go to is a walgreen's specialty pharmacy for people with chronic conditions.  The pharmacy manager has been able to work miracles for me in dealing with all the red tape.  It might be worth it to check with your pharmacy manager to see what they can do ... don't want to give any false hope but it's worth a shot.

AA

[J.R.E.]

I decided to post this because there may be other Humana insured on this site and they may not know about this.  I continue to hope that our political leaders will find a way to give everyone the dignity of adequate health care rather than reserving it for the privileged or lucky few.

Gary

Hello Gary,

I received probably the same identical letter, Saturday in the mail. Also from Humana :
Epzicom went up another tier level...

http://forums.poz.com/index.php?topic=24185.0


Ray

[ArisGreekSquared]

I work for a healthcare system here in Boston and Atripla on our company Medco prescription insurance is 20.00 per month for Atripla because its Tier 2.  It's dirt cheap. The highest prescription tier we have is $25 (tier 3).  It's kind of funny because when I started meds in August, my Walgreens receipt said "Your insurance paid 1683.72" and I went to get it under 2 weeks ago and it said "Your insurance covered 1742.11".  Atripla went up in price but my co-pays are the same for another 3 years.  Perhaps thats why they are putting it up a tier in some insurances.

[hades01]

Hi,
I am about to stary atripla and findout that my copay with cigna health insurance is $100 for 30 day supplly and $250.00 for 90 day by mail order.

[Bizmark33]

Shoot. SHoot, shoot, shoot. I JUST found out my emplyer is switching insurance companies. I have NO idea what the co-pay is for Atripla, but if it is too outragous, I will have to find other employment to get my ONE med. I am thinking about seriously getting that three month supply thing going. I wonder what I need to do, contact my Dr, or what? Supposidly the pharmacy at the place I work will fill a three moth supply for a two month co-pay, BUT I am not real keen on getting my meds from my emplyer. It's really none of thier damn business what meds I am on.

[aztecan]

I know someone who pays the percentage copay for his Atripla.

His copay was $422 a month.

The operative word is "was," because his copay just went to $431 a month this month.

From what I can gather, I think the price of Atripla went up.

I wonder if taking Sustiva/Truvada is still cheaper?

HUGS,

Mark

[Lou-ah-vull]

On Humana's new formulary, Truveda is still Level 2 ($30 copay) and Sustiva is not listed (probably also level 2 at $30).  Thus, not cheaper than Atripla at level 3 ($50 copay.)

Gary

[bufguy]

I consider myself very lucky. I'm a civil servant and pay nothing for my BC/BS insurance premium. My Atripla is a tier 2 drug which costs me $10. I just started mailorder through MEDCO and it will be $10 for 3 months supply. Honest to God we need National Healthcare for these life saving drugs.

[hotpuppy]

Well, I think it's important to count your blessings.  Those with insurance are blessed. Those who get their meds free from the gov't are blessed.  Those in the middle are screwed.  I am currently in a drug study so I get mine for free... or as I like to joke, I sell blood for drugs.

I will eventually have coverage through the Texas High Risk pool, which is guaranteed issue.  The premium is $420/mo which isn't great, but it sure beats nothing.  Drug coverage will be $200 deductible/yr and $25/generic co-pay, $35 co-pay for most HIV meds, and they have a higher one as well.  I believe there is a $60, 3 month mail order program as well. 

I know two other poz guys who have trouble taking meds because they cannot afford the co-pays.  One has co-pays that wind up being $600/mo and the other had a lapse in coverage between employers. 

Be grateful for what you have, many have less.  Besides having a good attitude is healthy.

[Bizmark33]

I hear ya. I AM greatful for what I have. Fearful more than anything that it'll reach the point that I won't be able to afford health coverage and copays, or that they will stop paying for my med. Then I'll really be screwed. I'm one of those in the middle, that without insurance, I couldn't get assistance, so....
     I'll never be able to go without insurance, that's for sure.

[PozitivelySouthern]

Wow! A lot of variance here on what people are paying for the same drug. My employer's insurance is a PPO and I personally pay $850 for a 3-month supply of Atripla through Caremark.

[dusty99]

Ok, I guess I am one of the fortunate ones, as my co-pay for ANY meds is $8, from the VA. I did pay a price with war and what not, but I guess that is the benefit of Military service. I am soon to be going on Atripla myself looks like this week.