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Author Topic: Cost of Stribild with Express Scripts, GHI, and medicare  (Read 449 times)

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Offline johnsteven51

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Cost of Stribild with Express Scripts, GHI, and medicare
« on: September 21, 2015, 08:19:09 PM »
I will soon be going on Medicare (March of 2016). My current coverage comes from GHI (now Emblem I guess) with Express Scripts for drug coverage. My Doctor said I might be in for a surprise at the cost once I go on Medicare and that I should maybe check it out. GHI will become my Madcap insurance and I will still be with Express Scripts for drugs. I see on their formulary, they have it on their level 5, (Most expensive drugs) and to call about cost. I will do that, but was wondering if anyone else has a similar situation that could shed some light.
I am on Stribild. Does anyone have any actual experience with going on Medicare.
I know the Donut hole is supposed to be disappearing, but is still there and am interested in knowing how that figures into the formula.
Thanks in advance,

Offline tednlou2

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Re: Cost of Stribild with Express Scripts, GHI, and medicare
« Reply #1 on: September 22, 2015, 12:30:03 AM »
I don't know the answer to your question.  I was curious whether you've checked to see if your qualify for the Extra Help program?

Offline johnsteven51

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Re: Cost of Stribild with Express Scripts, GHI, and medicare
« Reply #2 on: September 22, 2015, 08:20:22 AM »
Thanks. Don't think I will qualify. Don't really live in the States and have a pretty good income and assets. I now live in Mexico, where, if worst comes to worst I can get Atripla for free, as I am on the National Health Insurance program there. I was just hoping to not  have to switch and I don't like using their resources if I have other resources available to me. Even with a good income and resources though, that 4600 donut hole is not a nice thought.
« Last Edit: September 22, 2015, 08:39:51 AM by johnsteven51 »

Offline freddyfox

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Re: Cost of Stribild with Express Scripts, GHI, and medicare
« Reply #3 on: October 25, 2015, 05:16:11 PM »
I'm in the same situation....on medicare now, and facing 4k in copay for triumeq. medicare seems to pay about 55% this year, with us paying the other 45% for tier 5. But you're right, that the doughnut hole while still there, will shrink each yr.  Next yr is will require patients to pay 40%, and then 35% the next yr during the hole, which at least is some consolation I guess. Unfortunately can't use those copay cards from the drug company when medicare is paying.  Ugh!

Offline freddyfox

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Re: Cost of Stribild with Express Scripts, GHI, and medicare
« Reply #4 on: October 25, 2015, 05:17:00 PM »
PS why don't you just take the Atripla, isn't it pretty similar?


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