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Author Topic: insurance surprise  (Read 2524 times)

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Offline ruralguy

  • Member
  • Posts: 141
insurance surprise
« on: November 13, 2009, 01:17:25 PM »
I've been on Atripla since mid September.

I called in to get my refill and, gee, surprise - my insurance has a med limit of $5000.  So all of a sudden, at $1500-2000 a month, I'm looking at some pretty big expense numbers.

What do I go to get Atripla for the lowest price??

tested positive June 19, 2009
7/3/09 vrl 9000 cd4 - 300
8/14/09 cd4 - 350, 20%
started Atripla 9/14/09
10/5/09 vrl undetectable, WOW so fast!
12/28/09 vrl undetectable, CD4 - 615  27% cholesterol down, kidney function normal
4/26/10 vrl undetectable, CD4-600, kidney and liver numbers normal
9/9/10 vrl undetectable, CD4-685
1/3/11 vrl undetectable, CD4-700
all 2011 and Jan 2012 visits vrl undetectable CD4 ranged from 715-645
5/7/2012  vrl undetectable, CD4-615, all liver, kidney, lipids, heart functions, etc normal


On Atripla:  "Your mileage may vary"

Offline Forevergreen

  • Member
  • Posts: 14
Re: insurance surprise
« Reply #1 on: November 13, 2009, 01:38:29 PM »
i'm not sure what your financial situation is, but you might qualify for assistance. i would look into local aids services and find out if you have any options.  :)

Offline Nashvegas

  • Member
  • Posts: 196
Re: insurance surprise
« Reply #2 on: November 13, 2009, 01:44:14 PM »
I share your pain, Ruralguy.  I've got a policy that has a $1,500 annual cap on prescriptions, so that should cover about one month's worth of meds.  Right now, I'm participating in a clinical trial that covers all my meds and testing, so that's been a godsend, but at the end of three years, I'll start paying for most of my meds out of pocket.  My understanding is that a lot of the ADAP plans have very low limits for assets, so that I wouldn't qualify for assistance.  So I'll be curious what you find out. 
8/12/06 - sero-conversion
9/14/06 -- Positive Test results confirmed
9/21/06 -- CD4 - 586; viral load 8,000; 29%
12/25/06 -- CD4 - 373; VL 2,800; 23%
2/10/07 - CD4 - 228; VL 865; 25%
3/15/07 -  CD4 - 365 (no viral load test)
5/1/07 = CD4 - 341; VL 4,358; 27%
8/1/07 - CD4 - 315; VL - 2,300; 25%
9/20/07 - CD4 - 378
11/22/07 - CD4 - 257; VL 7,300;
2/27/08 - CD4 231 (16.5 %), VL 5,960
5/20/08 - CD4 229 (18.3%), VL 11,100
6/17/08 - CD4 166 (14.5%), VL 9,030
6/17/08 - STARTED VIRAMUNE + TRUVADA
7/2/08 - CD4 272 (20%), VL 113  :-)
7/16/08 - CD4 -217 (21.1 %), VL - Undetectable
7/30/08 - CD4 - 220 (20.4%). VL - 92
8/14/08 - CD4 - 280 (22%) VL-undetectable
1/04/09 - CD4 - 250 (28%) VL-UD
5/15/09 - CD4 -393 (28%) VL-UD
8/15/09 - CD4-346, (26%) VL-UD
11/15/09 - CD4-373 (28%)

Offline tommy246

  • Standard
  • Member
  • Posts: 435
Re: insurance surprise
« Reply #3 on: November 13, 2009, 05:22:44 PM »
the bottle i have 30 pills in spain says approx 750 euros.
jan 06 neg
dec 08 pos cd4 505 ,16%, 1,500vl
april 09 cd4 635 ,16%,60,000
july 09 ,cd4 545,17%,80,000
aug 09,hosptal 18days pneumonia cd190,225,000,15%
1 week later cd4 415 20%
nov 09 cd4 591 ,vl 59,000,14%,started atripla
dec 09  cd4 787, vl 266, 16%
march 2010  cd4 720 vl non detectable -20  20%
june 2010  cd4  680, 21%, ND

Offline Ann

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  • Member
  • Posts: 28,140
  • It just is, OK?
    • Num is sum qui mentiar tibi?
Re: insurance surprise
« Reply #4 on: November 13, 2009, 05:48:53 PM »
the bottle i have 30 pills in spain says approx 750 euros.

At the current rate of exchange, 750.00 EUR = 1,117.70 USD.
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Offline LBpozguy

  • Member
  • Posts: 51
Re: insurance surprise
« Reply #5 on: November 15, 2009, 03:35:02 PM »
$1,117.70 us is pretty good. When I get my refill from Rite Aid, they have it broken down and my insurance is billed $1773.00. It scares me to think that I would ever have to pay that myself out of pocket. :(
Feb 08 neg
Sept 08 - First poz test
Sept 08 CD4 558 (% unk) VL 11000
Dec 08 CD4 480 (29%) VL less than 700
Mar 09 CD4 370  VL 25000
June 09 CD4 425 VL 68000
Aug 09 Started Atripla
Sept 09 CD4 639 VL 100
Nov 09  CD4 716 (35%) VL Undet!!!!!!!!!!!!!
Jan 10 CD4 685 VL UND

Offline beau1200

  • Member
  • Posts: 17
Re: insurance surprise
« Reply #6 on: November 16, 2009, 01:51:08 AM »
Depending on your situation, you could check with the Ryan White fund.  They offer support getting medication.  They can also help with insurance premiums.  There are also nonprofit HIV support groups/centers that can help you with some of the cost. 

We have project open hand and positive impact, and AIDS Atlanta.  Not sure what centers you might have in your city.  It's worth checking into. 

Hope this helps.
Best Wishes 

Offline Oceanbeach

  • Member
  • Posts: 3,565
Re: insurance surprise
« Reply #7 on: November 16, 2009, 10:26:41 PM »
I would suggest you also ask your Case Manager about ADAP assistance.   ;D  Have the best day
Michael
(who has heard "We can't let you leave this pharmacy with $3000 in meds without payment.")

Offline waldo59

  • Member
  • Posts: 5
  • "you wanta put what.....where"
Re: insurance surprise
« Reply #8 on: November 24, 2009, 04:46:07 PM »
I dont see much discussion of the VA here in the forum but its an excellent source of hiv care for veterans  depending on your circumstances atripla can be free or as little as $8.00 a bottle.

Offline rick21007

  • Member
  • Posts: 286
Re: insurance surprise
« Reply #9 on: November 24, 2009, 05:26:00 PM »
Bristol-Myers Squibb also offers a patient assistance program for Atripla.  You can down load the app. off their website and fill it out and have it signed by your prescribing MD and see if you qualify.  My experience is that the drug company P.A. programs also have made exceptions to their stated qualifying policies.

Rick

Offline ruralguy

  • Member
  • Posts: 141
Re: insurance surprise
« Reply #10 on: November 25, 2009, 05:12:08 PM »
Just appealing for some discount from the drug company a good idea, although I'd be an exception.  Maybe with all the health care scare they'll be flexible.  If I were brave enough I suppose I couldn't say I'll try to make my case a public point about why health care here is so broken.

I just don't qualify for the ususal government programs.  So far the best price I can find is $1550 for 30 tabs via the Costco online pharmacy.

tested positive June 19, 2009
7/3/09 vrl 9000 cd4 - 300
8/14/09 cd4 - 350, 20%
started Atripla 9/14/09
10/5/09 vrl undetectable, WOW so fast!
12/28/09 vrl undetectable, CD4 - 615  27% cholesterol down, kidney function normal
4/26/10 vrl undetectable, CD4-600, kidney and liver numbers normal
9/9/10 vrl undetectable, CD4-685
1/3/11 vrl undetectable, CD4-700
all 2011 and Jan 2012 visits vrl undetectable CD4 ranged from 715-645
5/7/2012  vrl undetectable, CD4-615, all liver, kidney, lipids, heart functions, etc normal


On Atripla:  "Your mileage may vary"

Offline Inchlingblue

  • Member
  • Posts: 3,119
  • Chad Ochocinco PETA Ad
Re: insurance surprise
« Reply #11 on: November 25, 2009, 10:18:50 PM »
Have you looked into Viraday, the generic Atripla?

It's made by a very reputable Indian company, Cipla.

There are several threads on here if you do a search.

It can be purchased online and there are several reputable online pharmacies. I've seen it going for about $165. for a 30 day supply or $450. for a 90 day supply

This thread mentions a couple of online pharmacies:

http://forums.poz.com/index.php?topic=28320.msg349272#msg349272
« Last Edit: November 25, 2009, 10:26:48 PM by Inchlingblue »

 


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