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Author Topic: Surprise!  (Read 3502 times)

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Offline aztecan

  • Member
  • Posts: 5,382
  • 29 years positive, 56 years a pain in the butt
Surprise!
« on: January 27, 2012, 08:00:52 PM »
Well, not really.

I picked up my meds today and found that my coupon that helps with my copay for Isentress is used up.

You get 12 refills, then that is it - for life. I guess I could hope that they might decide to re-issue another coupon, but I won't hold my breath.

My copays went from about $73 a month to $276 a month.

I guess nothing lasts forever.

HUGS,

Mark

« Last Edit: January 27, 2012, 08:05:12 PM by aztecan »
"May your life preach more loudly than your lips."
~ William Ellery Channing (Unitarian Minister)

Offline denb45

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  • Posts: 5,051
  • "1987 Classic Old School POZ+"
Re: Surprise!
« Reply #1 on: January 27, 2012, 08:04:17 PM »
Well, not really.

I picked up my meds today and found that my coupon that helps with my copay for Isentress is used up.

You get 12 refills, then that is it - for life, or so the pharmacist told me the pharma site told him.

It was nice while it lasted. My copays went from about $73 a month to $276 a month.

I guess nothing lasts forever.

HUGS,

Mark

 :(  anything else you can do Mark
"it's so nice to be insane, cause no-one ask you to explain" Helen Reddy cc 1974

Offline aztecan

  • Member
  • Posts: 5,382
  • 29 years positive, 56 years a pain in the butt
Re: Surprise!
« Reply #2 on: January 27, 2012, 08:07:18 PM »
:(  anything else you can do Mark

No, not really. I thought of switching meds, but you might remember the problems I had with that when I was looking at switching because of side effects.

So, I will just grin and bare it, so to speak. ;)

HUGS,

Mark
"May your life preach more loudly than your lips."
~ William Ellery Channing (Unitarian Minister)

Offline denb45

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  • Posts: 5,051
  • "1987 Classic Old School POZ+"
Re: Surprise!
« Reply #3 on: January 27, 2012, 08:12:29 PM »
No, not really. I thought of switching meds, but you might remember the problems I had with that when I was looking at switching because of side effects.

So, I will just grin and bare it, so to speak. ;)

HUGS,

Mark

Well a got about 2 to 3 bottles of extra Isentress I keep in a stock pile ( incase of whatever)  :-X

EDITED: to Add  $276 a month  Dayumm Mark that's a brand New Truck Payment for me each month, that's why I don't want to buy a new one just yet  :o
« Last Edit: January 27, 2012, 08:30:36 PM by denb45 »
"it's so nice to be insane, cause no-one ask you to explain" Helen Reddy cc 1974

Offline chiarasun

  • member
  • Posts: 2
  • POZ+ since 1984 & still smiling 1 day at a time :)
Re: Surprise!
« Reply #4 on: January 27, 2012, 11:31:04 PM »
sorry to hear that  :( ...i wait not only for a vaccine and cure BUT ALSO for the meds now to be cheaper and made available for everyone who needs them... hugs

Offline aztecan

  • Member
  • Posts: 5,382
  • 29 years positive, 56 years a pain in the butt
Re: Surprise!
« Reply #5 on: January 28, 2012, 12:48:51 AM »
sorry to hear that  :( ...i wait not only for a vaccine and cure BUT ALSO for the meds now to be cheaper and made available for everyone who needs them... hugs

I hear you. I am lucky enough to be able to get meds, even if I pay more than I would like. When i think of all those on waiting lists here in the U.S. or who, in other lands, cannot get the meds they need, I realize just how lucky I am.

By the way, welcome to the forums. Glad you have joined in

When you get a moment, tell us a bit more about yourself. We're a pretty good group here.

HUGS,

Mark

"May your life preach more loudly than your lips."
~ William Ellery Channing (Unitarian Minister)

Offline BT65

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  • Vegas baby!
Re: Surprise!
« Reply #6 on: January 28, 2012, 04:52:07 PM »
Mark, WTF?  That's insane.  Is that the patient assistance program?  Those drug company pricks can be a real pain.  One of our clients went back to Uganda because the drug company was going to kick her off and she could get no other assistance. 

Those co-pays are horrendous.  I wish there was something else that could be done. >:(
I've never killed anyone, but I frequently get satisfaction reading the obituary notices.-Clarence Darrow

Offline J.R.E.

  • Member
  • Posts: 7,093
  • Joined Dec-2003 Living positive, since 1985.
Re: Surprise!
« Reply #7 on: January 29, 2012, 04:31:25 AM »


That's shitty news Mark.   Damn ,  I hope there may be some other alternative for you, to help with the co-pays.

Ray
Current Meds ; Viramune, Epzicom, 40mg of simvastatin, 12.5mg of Hydrochlorothiazide.
Metoprolol tartrate 25mg



http://forums.poz.com/index.php?topic=40802.0

http://forums.poz.com/index.php?topic=45159.0

http://forums.poz.com/index.php?topic=39722.msg495621;topicseen#msg495621

http://forums.poz.com/index.php?topic=46806.0

http://forums.poz.com/index.php?topic=39414.msg491701#msg491701


 In October of 2003, My t-cell count was 16, Viral load was over 500,000, Percentage at that time was 5%. I started my first  HAART regimen  on October 24th,03.

 As of 6/4/14,  t-cells are at 423, Viral load <40

 Current % is at 13% 

  
 62 years young.

Offline Theyer

  • Member
  • Posts: 2,464
  • Current ambition. Walk the Dog .
Re: Surprise!
« Reply #8 on: January 29, 2012, 09:00:49 AM »
I am sorry Mark also angry, wtf is the thinking , well I know the the thinking is ,get them started , And how many ways, routes methods off drug payment are there.

Anyway have wanted to say for a long time fantastic head wear worn beautifully.
lots off love and hugs
theyer



ed to add
looklook my 900 post
« Last Edit: January 29, 2012, 09:04:12 AM by Theyer »
"If we can find the money to kill people, we can find the money to help people ."  Tony Benn

Offline aztecan

  • Member
  • Posts: 5,382
  • 29 years positive, 56 years a pain in the butt
Re: Surprise!
« Reply #9 on: January 29, 2012, 12:12:49 PM »
Mark, WTF?  That's insane.  Is that the patient assistance program?  Those drug company pricks can be a real pain.  One of our clients went back to Uganda because the drug company was going to kick her off and she could get no other assistance. 

Those co-pays are horrendous.  I wish there was something else that could be done. >:(

Yeah Betty, that is how the Isentress coupon works. I am not sure that all are that way, but I wouldn't be surprised. Prior to this, they had a coupon you could renew each year. They paid all but $30 of the copay. Then they changed to a coupon that pays 100 percent of the copay, but you get 12 refills and then that's it for life.

I tried to plan ahead for this by putting money back to cover it, but there always seems to be something that comes up that costs money it doesn't leave me any wiggle room, so to speak.

Sorry to hear about the woman who went back to Uganda. That happens more often than people realize.

HUGS,

Mark
"May your life preach more loudly than your lips."
~ William Ellery Channing (Unitarian Minister)

Offline aztecan

  • Member
  • Posts: 5,382
  • 29 years positive, 56 years a pain in the butt
Re: Surprise!
« Reply #10 on: January 29, 2012, 12:16:52 PM »
Anyway have wanted to say for a long time fantastic head wear worn beautifully.
lots off love and hugs
theyer

ed to add
looklook my 900 post

Congrats on the 900th post and thank you for the compliment on the hat. The photo was taken during AMG last year in Seattle. Actually, it was an outing to Mt. Ranier. The hat went missing shortly thereafter when I carelessly left it on a table in the hotel lobby.
So, this year, I will have to get another.

HUGS.

Mark
« Last Edit: January 29, 2012, 09:59:10 PM by aztecan »
"May your life preach more loudly than your lips."
~ William Ellery Channing (Unitarian Minister)

Offline denb45

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  • Posts: 5,051
  • "1987 Classic Old School POZ+"
Re: Surprise!
« Reply #11 on: January 29, 2012, 12:19:49 PM »
Y

I tried to plan ahead for this by putting money back to cover it, but there always seems to be something that comes up that costs money it doesn't leave me any wiggle room, so to speak.


HUGS,

Mark

SHIT mark can you get your doctor to change Isentress to something else? I mean I'm on that too, but I cannot understand for the life of me why I'm still on the horrid Travada w/ the kidney issues I already have.......


this make me MAD  >:(  there has to be a solution to this problem, ask your doctor if you think it will help  ???
« Last Edit: January 29, 2012, 12:23:48 PM by denb45 »
"it's so nice to be insane, cause no-one ask you to explain" Helen Reddy cc 1974

Offline J.R.E.

  • Member
  • Posts: 7,093
  • Joined Dec-2003 Living positive, since 1985.
Re: Surprise!
« Reply #12 on: January 29, 2012, 05:43:13 PM »
Yeah Betty, that is how the Isentress coupon works. I am not sure that all are that way, but I wouldn't be surprised.
HUGS,

Mark

The Epzicom assistance card was good for 2 years, and paid up to 100.00 per month in co-pays.  That helped me quite a bit.  My co-pay, for the Epzicom ( at that time ) was $50.00,  so it wiped that co-pay out completely.


Ray
Current Meds ; Viramune, Epzicom, 40mg of simvastatin, 12.5mg of Hydrochlorothiazide.
Metoprolol tartrate 25mg



http://forums.poz.com/index.php?topic=40802.0

http://forums.poz.com/index.php?topic=45159.0

http://forums.poz.com/index.php?topic=39722.msg495621;topicseen#msg495621

http://forums.poz.com/index.php?topic=46806.0

http://forums.poz.com/index.php?topic=39414.msg491701#msg491701


 In October of 2003, My t-cell count was 16, Viral load was over 500,000, Percentage at that time was 5%. I started my first  HAART regimen  on October 24th,03.

 As of 6/4/14,  t-cells are at 423, Viral load <40

 Current % is at 13% 

  
 62 years young.

Offline Miss Philicia

  • Member
  • Posts: 23,872
  • celebrity poster, faker & poser
Re: Surprise!
« Reply #13 on: January 29, 2012, 06:13:39 PM »
Mark, WTF?  That's insane.  Is that the patient assistance program?  Those drug company pricks can be a real pain.  One of our clients went back to Uganda because the drug company was going to kick her off and she could get no other assistance. 

Those co-pays are horrendous.  I wish there was something else that could be done. >:(

Aside from that fact that drug prices are high, shouldn't we look at it that they're being generous even having these assistance programs? They never used to. The issue here IMO is that Mark's insurance coverage has such high co-pays. If insurance programs didn't rape their customers and had realistic co-pays like they did a mere decade ago (when I was last on private insurance I never paid more than $15 for a non-generic).
"Iíve slept with enough men to know that Iím not gay"

Offline Pozzy1

  • Member
  • Posts: 10
Re: Surprise!
« Reply #14 on: January 29, 2012, 08:10:18 PM »
It is a real crime how expensive our meds are in this country.  I currently am getting my co-pay picked up by the manufacturer of Atripla and hope hat I don't end up in the same situation as you. 


Offline Dachshund

  • Member
  • Posts: 5,941
Re: Surprise!
« Reply #15 on: January 29, 2012, 08:25:18 PM »
Aside from that fact that drug prices are high, shouldn't we look at it that they're being generous even having these assistance programs? They never used to. The issue here IMO is that Mark's insurance coverage has such high co-pays. If insurance programs didn't rape their customers and had realistic co-pays like they did a mere decade ago (when I was last on private insurance I never paid more than $15 for a non-generic).

Yep, that's the rub. I enrolled in the pre-existing condition insurance offered by the government. My premium would have been $425 a month which I could have managed. On the other hand the copay for the three drugs I take would have been $600 a month. Can't swing that, so I had to cancel.

Online Jeff G

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  • How am I doing Beren ?
Re: Surprise!
« Reply #16 on: January 29, 2012, 08:37:38 PM »
I was looking for a medigap policy to cover what medicare doesn't pick up . I learned that Alabama is one of the states that doesn't require insurance company's to cover people under a certain age , I think its 65 ... so I'm just hoping that nothing major happens to me before then because if it did I would be in big trouble financially . I'm hoping that insurance company's have to extend coverage after 2014 when health reform laws take affect .

Offline aztecan

  • Member
  • Posts: 5,382
  • 29 years positive, 56 years a pain in the butt
Re: Surprise!
« Reply #17 on: January 29, 2012, 10:10:04 PM »
Aside from that fact that drug prices are high, shouldn't we look at it that they're being generous even having these assistance programs? They never used to. The issue here IMO is that Mark's insurance coverage has such high co-pays. If insurance programs didn't rape their customers and had realistic co-pays like they did a mere decade ago (when I was last on private insurance I never paid more than $15 for a non-generic).

Yes, aside from the meds just costing a lot, it is the manner in which the insurance companies have passed along some of the costs to those with the coverage. In the past, there were set copays for generics and for non-generics.
Today though, most prescription coverage is a tier system, with tier 1 being the generics, tier 2 the meds with no generic equivalents, tier 3 the non-generics that are somewhat more costly, and tier 4, (and I forget the term they use) contains the most costly meds.
In tier 4, there is no set copay, it is a percentage of the total cost of the medication. I am lucky in one respect. Isentress is less costly than Atripla.
I know some people whose copays for Atripla exceed $500 a month.

It can be insane.

HUGS,

Mark
"May your life preach more loudly than your lips."
~ William Ellery Channing (Unitarian Minister)

Offline Miss Philicia

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  • celebrity poster, faker & poser
Re: Surprise!
« Reply #18 on: January 29, 2012, 11:20:02 PM »
I'll also add that the same insurance company probably offers a variety of plans, some with less tiered co-pays but which would mean a higher premium to your employer (which then also sometimes depending on employer is passed on in some amount to the employee). So really it's a combination of the insurer and the employer.

It's always hard for the consumer (patient) to rightly say who is squeezing who. It's not a very transparent arraignment. Back when I was working I was the one who met with insurance brokers for our office to negotiate our policy, so I saw what it was like every year.

I guess what's really sad is that you work for an ASO that doesn't have the budget means to offer their employees who have HIV a policy with lower co-pays. That's what really struck me when I first read the thread.
"Iíve slept with enough men to know that Iím not gay"

Offline Jeffreyj

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Re: Surprise!
« Reply #19 on: January 30, 2012, 06:33:06 AM »
Mark, I sent you a PM that might help you out.
Hang in there bud.
Jeff
Positive since 1985

Offline aztecan

  • Member
  • Posts: 5,382
  • 29 years positive, 56 years a pain in the butt
Re: Surprise!
« Reply #20 on: January 30, 2012, 10:43:41 AM »
I'll also add that the same insurance company probably offers a variety of plans, some with less tiered co-pays but which would mean a higher premium to your employer (which then also sometimes depending on employer is passed on in some amount to the employee). So really it's a combination of the insurer and the employer.

It's always hard for the consumer (patient) to rightly say who is squeezing who. It's not a very transparent arraignment. Back when I was working I was the one who met with insurance brokers for our office to negotiate our policy, so I saw what it was like every year.

I guess what's really sad is that you work for an ASO that doesn't have the budget means to offer their employees who have HIV a policy with lower co-pays. That's what really struck me when I first read the thread.

Very true. For the agency, it is a balancing act, trying to provide adequate coverage while not breaking the bank. We did have another option, but that would have cost me an extra $200 a month and didn't offer better prescription coverage.

The extra money basically created an HMO type of coverage, meaning the $1,000 deductible we have disappeared. But it would cost an extra $2,400 a year. The agency also took out an extra type of policy that reimburses us for our deductible, so choosing the more expensive option was not really a logical choice.

But, I digress.

This tiered option started appearing three or four years ago, although it may have started sooner. I see it all the time.

We have a program to help those who are clients cover these costs, which has been a lifesaver for many people.

I am not eligible for it, but it is a great program.

HUGS,

Mark
"May your life preach more loudly than your lips."
~ William Ellery Channing (Unitarian Minister)

Offline denb45

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  • "1987 Classic Old School POZ+"
Re: Surprise!
« Reply #21 on: January 30, 2012, 11:27:28 AM »


We have a program to help those who are clients cover these costs, which has been a lifesaver for many people.

I am not eligible for it, but it is a great program.

HUGS,

Mark

I probably be DEAD if it weren't for THIS:

https://members.hcsc.net/members/mbrsignon_nm.html

and THIS:

http://www.nmmip.com/2009/medcon.htm

Of Course, I had to sign over all of my Medicare Parts A, B and D to help pay for this, as I wasn't dual ineligible for QMB ( the State part that pays for your Medicare premiums each month  :-[

SO now for the last 3 yrs. I'm losing $1,400 dollars a yr. or $99.99 a month form my SSDI  ::)

and I'd like to Thank Mark for getting me the info about this program, Mark you are a scholar & and true gentleman Mr. Mark Lewis  :-*  I'd be dead or very sick if it wasn't for you......however the amount of co-pays you have to endure just makes me wanna spit  >:(
« Last Edit: January 30, 2012, 11:29:21 AM by denb45 »
"it's so nice to be insane, cause no-one ask you to explain" Helen Reddy cc 1974

Offline Miss Philicia

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  • celebrity poster, faker & poser
Re: Surprise!
« Reply #22 on: January 30, 2012, 11:38:42 AM »

SO now for the last 3 yrs. I'm losing $1,400 dollars a yr. or $99.99 a month form my SSDI  ::)

I pay around the same amount of money, or $93/mo, for some weird loop-hole policy our state has where they essentially put me on Medicaid as my secondary insurance but they call the program something else. But I also have $96.50 taken out of my SSI for Medicare (A & B).

Mark, though, must be paying co-pays for other meds on top of this latest one and I assume he must shell out for something for doctors visits, etc.
« Last Edit: January 30, 2012, 12:05:07 PM by Miss Philicia »
"Iíve slept with enough men to know that Iím not gay"

Offline denb45

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  • "1987 Classic Old School POZ+"
Re: Surprise!
« Reply #23 on: January 30, 2012, 11:59:04 AM »
I pay around the same amount of money, or $93/mo, for some weird loop-hole policy our state has where they essentially put me on Medicaid as my secondary insurance but they call the program something else. But I also have $96.50 taken out of my SSI for Medicare.

Mark, though, must be paying co-pays for other meds on top of this latest one and I assume he must shell out for something for doctors visits, etc.

I still have Co-pays for doctors visits, and co-pays for all non AVRs, but they aren't over 20 or 30 dollars, and they aren't anywhere near what poor Markus has to pay  :-[
"it's so nice to be insane, cause no-one ask you to explain" Helen Reddy cc 1974

Offline deibster

  • Member
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Re: Surprise!
« Reply #24 on: February 02, 2012, 07:35:15 PM »
Sorry to here that Mark.
Is the Northeast the only area that still has decent ADAP, HDAP here in MASS? I don't pay any copays for things I get from my mail order pharmacy here in Boston. I have prescription insurance from Medco with my disability pension. If I have to get something quickly, a pain pill or antibiotic, I pay about $10 here at the local pharmacy. Hugs, Deiby
Poz since Dec 1992. Meds since 1995. Disability since 2005.

Prezista/Norvir, Epzicom, Cytomel, Prevacid, pravastatin, Fenofibrate, Remeron, Zoloft, Concerta, doxazosin, Allegra180, Nasocort, Centrum, Flax Oil, Fish Oil

 


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