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Author Topic: What can I do?  (Read 6401 times)

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Offline Brad101210

  • Member
  • Posts: 11
What can I do?
« on: February 22, 2011, 12:53:57 AM »
I live in California and have Kaiser for my insurance. Long story short...I'm paying 325.00 a month for my medications,( because there non-formulary meds).  I make about 65,000 a year and don't qualify for any assistance. I've already contacted Prezista and my other drug companies. But was told that I make too much money for assistance. Does anyone have any suggestions that I might try? I also went to the local Gay and Lesbian center but was told that they couldn't help me because I had insurance. I would appreciate any suggestions.
10-12-10 Tested Positive
11-02-10 CD4: 185 VL: 35,000
11-16-10 Started Norvir, Truvada, Reyataz.
12-08-10 CD4: 223 VL: 427
01-10-11 Allergic to Reyataz. Started Norvir, Prezista, Isentress, Truvada
02-07-11 CD4: 284 VL: UD
05-10-11 CD4: 292 VL: UD
08-16-11 CD4: 322 VL: UD

Offline PosIntheCValley

  • member
  • Posts: 1
Re: What can I do?
« Reply #1 on: February 22, 2011, 01:36:02 AM »
I have Kaiser in California as well. Not sure which plan you have, but my partner and I have never been prescribed anything that was not covered. Maybe you could ask your ID Doctor if there is an equivalent drug to what he is prescribing you. You would be surprised at how helpful your Doctor might be. Sometimes as Doctors they may not realize that your particular plan isn't covering a drug he is prescribing.

Hope this helps.

Offline ds4146

  • Member
  • Posts: 317
Re: What can I do?
« Reply #2 on: February 22, 2011, 09:29:22 AM »
I also live in California and had the same problem. I currently have a Co-Pay Card for Truvada which pays for half the cost and a "Master Card" for Viramune which pays the entire amount. I got both from Mom's Pharmacy which teamed up with Being Alive here in San Diego. I know that there a number of programs similar to that, however you will need to research the other options. Hope that helps some.

Offline richie

  • Member
  • Posts: 69
Re: What can I do?
« Reply #3 on: February 22, 2011, 11:58:27 PM »
Get some co-pay cards -- like this one for Truvada:

http://www.truvada.com/pat410_copay_assistance_program.aspx

There's one for Norvir as well.  These will help defray copays (even with insurance).

Here's one for Prezista:

http://www.prezista.com/patients/important-resources/patient-savings-program

Online edfu

  • Member
  • Posts: 1,084
Re: What can I do?
« Reply #4 on: February 23, 2011, 01:19:36 AM »
These programs are limited by income.  The OP appears to be over the limit.   
"No one will ever be free so long as there are pestilences."--Albert Camus, "The Plague"

"Mankind can never be free until the last brick in the last church falls on the head of the last priest."--Voltaire

Offline leatherman

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  • Posts: 6,051
  • Google and HIV meds are Your Friends
Re: What can I do?
« Reply #5 on: February 23, 2011, 03:10:55 AM »
Maybe you could ask your ID Doctor if there is an equivalent drug to what he is prescribing you.
there is a proposed bill in SC that would limit Medicaid to only purchasing generic drugs. However, the only antiretrovirals that are available in America in generic form are AZT and ddI. In the world of antiretrovirals there is no such thing as an equivalent medication. :(
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Offline ds4146

  • Member
  • Posts: 317
Re: What can I do?
« Reply #6 on: February 23, 2011, 09:28:27 AM »
Brad, I can assure you that the two I mentioned are not limited to income level. Or they were not and have not been an issue as of last month and you and I are in similar salary ranges.

Offline denb45

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  • Posts: 5,051
  • "1987 Classic Old School POZ+"
Re: What can I do?
« Reply #7 on: February 23, 2011, 10:07:40 AM »
These programs are limited by income.  The OP appears to be over the limit.  

???
« Last Edit: February 23, 2011, 10:12:11 AM by denb45 »
"it's so nice to be insane, cause no-one ask you to explain" Helen Reddy cc 1974

Offline richie

  • Member
  • Posts: 69
Re: What can I do?
« Reply #8 on: February 23, 2011, 12:13:22 PM »
These programs are limited by income.  The OP appears to be over the limit.   
No, there's no income limit to these cards (trust me, I know based on my income).  You're probably thinking of the "assistance" programs, not the co-pay programs.  The first pays for all the drugs entirely, hence the income limits.  The Co-pay card only pays for the insurance co-pays, which can be significant.  For example, my 90-day co-pays would be about $900 - $1,200 dollars (even with insurance).  But the co-pay cards make it -0-. 

Offline denb45

  • Member
  • Posts: 5,051
  • "1987 Classic Old School POZ+"
Re: What can I do?
« Reply #9 on: February 23, 2011, 12:57:07 PM »
No, there's no income limit to these cards (trust me, I know based on my income).  You're probably thinking of the "assistance" programs, not the co-pay programs.  The first pays for all the drugs entirely, hence the income limits.  The Co-pay card only pays for the insurance co-pays, which can be significant.  For example, my 90-day co-pays would be about $900 - $1,200 dollars (even with insurance).  But the co-pay cards make it -0-.  

Case-in-point, my lipitor cost $115 dollars and is NOT covered by my states ADAP, or my Blue Cross- risk- pool Insurance, so with the discount-card-plan , I get a 90 day supply for a whole yr. the caught is, I have to pick this up @ my Doctors office every 90 days, and this cost me ZERO  ;)
"it's so nice to be insane, cause no-one ask you to explain" Helen Reddy cc 1974

Offline Brad101210

  • Member
  • Posts: 11
Re: What can I do?
« Reply #10 on: March 10, 2011, 10:37:51 PM »
Thanks everyone for your feedback...my doctor is scheduling me with a social worker that might be able to help me out. I appreciate all your comments....this is all so new to me and I've got so much to learn yet. Does it ever get any better? Or is it just downhill from now on?
10-12-10 Tested Positive
11-02-10 CD4: 185 VL: 35,000
11-16-10 Started Norvir, Truvada, Reyataz.
12-08-10 CD4: 223 VL: 427
01-10-11 Allergic to Reyataz. Started Norvir, Prezista, Isentress, Truvada
02-07-11 CD4: 284 VL: UD
05-10-11 CD4: 292 VL: UD
08-16-11 CD4: 322 VL: UD

Offline denb45

  • Member
  • Posts: 5,051
  • "1987 Classic Old School POZ+"
Re: What can I do?
« Reply #11 on: March 10, 2011, 10:43:26 PM »
Thanks everyone for your feedback...my doctor is scheduling me with a social worker that might be able to help me out. I appreciate all your comments....this is all so new to me and I've got so much to learn yet. Does it ever get any better? Or is it just downhill from now on?

It get's better, trust me as long as you remain pro-active, just doing nothing, won't get you squat, benefits just don't land into you hands that way........good luck to you  ;)
"it's so nice to be insane, cause no-one ask you to explain" Helen Reddy cc 1974

 


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