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extreme changes in copays

Discussion in 'Parents of Children with Type 1' started by goochgirl, Mar 10, 2012.

  1. goochgirl

    goochgirl Approved members

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    We just ordered 3 months of strips and insulin for the first time using our new insurance. When we moved, we had a good 6 months worth of supplies stored. Knowing we would be laid off, I was stingy and hoarded as much as I could. Our new insurance is, well, I'm at least grateful that we have some... Our copay for the strips and Apidra (yes, it was for the insurance recommended strips) for a 3 month supply was $250. This is for 100 fewer strips and 3 bottles of insulin less than what we got with our $30 copay from our last insurance company. I'm afraid to find out what our pump supplies will be (ordering this week). I am also paying $180/month for medications for one of my non-D kids. Does anyone else have copays this high???? Is this the direction all health insurance is going? Is this due to Obama's healthcare reform or the economy in general?
     
  2. Michelle'sMom

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    Apidra has a $0 copay offer for those with insurance. The site says it expires in April, but word from the endo's office is the offer has been extended through the end of the year. You can sign up here:
    http://www.apidra.com/copaycard/default.aspx
     
  3. BrendaMc

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    I just paid $20 for 900 strips, $20 for 6 bottles of insulin and $30 for 5 tubes of emla and 2 glucagons. I'm so thankful for our insurance.
     
  4. bandmkolb

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    My kids have CHIPS through the state of TX, it just went up from 25 each for humalog and lantus to 35. Supplies used to be 8 each and are now 35 each. When I found out, I was very upset, then I thought I should just be thankful we have it. My worry is that we will be switching to the pump sometime soon and we were told at one time that all DME is covered 100%... Maybe that's changed as well?
     
  5. lgouldin

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    $50 for a box of Lantus pens, $50 for a box of Novolog pens, $10 for 2 boxes of needles through pharmacy after our $150 deductible.... The strips are covered though DME and will pay 80% when we meet our deductible of $2000...so basically they pay for none of our strips.:eek:
     
  6. jessicat

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    We used to pay 30 for each script for 90 day supply. As of Jan 1 it is now $40 for each. But when we switch to the pump all our Durable med supplies are covered 100%
     
  7. TheFormerLantusFiend

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    What was it, item by item? My first order of the year looks more expensive because I have $200 deductibles on sensors and on the other prescriptions, separately. After those are paid, I pay 10% for sensors and $50 per prescription.
     
  8. caspi

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    Did you call the insurance company and ask them why? Since this was the first time using your new insurance, is it possible you had a deductible? I don't know what strips you use, but a few companies have programs with a very low co-pay that you may want to check out.

    In answer to your original question, our copays and premiums have remained the same.
     
  9. Mish

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    Most insurance companies have that information online. There shouldn't be a whole lot of surprise.
     
  10. Jordansmom

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    Sorry you're getting gouged. Our insurance coverage improved this year. Plus my young adult kids are covered for the first time in years because of Obamacare.

    We should pay $35 a month for Apidra, but it's been free since she went on it 2 years ago because of Apidra's copay savings card. You can't use your mail order for three months and use the card. But free is worth the hassle of filling monthly.
     
  11. sarahspins

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    Apidra would be $65 a month for me without my card.

    I'm on several other medications and my monthly pharmacy total is still around $100 (with the free Apidra). Mail order doesn't actually give me any kind of discount now so there is zero incentive to go that route.

    Ironically when we changed insurance last time, our Rx co-pays went way up, but the contract rate for supplies went WAY down.. what used to cost about $600 for a 3 month supply is now $285.
     
  12. mmgirls

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    every year for the past 3 years copays and dedutables have gone up. Same company and same insurance carrrier. started at $10 copay and 100%DME and we are now to $30-40 copays and 20% DME that I pay.

    I stocked up on what I could towards the end of the year and I will have to do it all year being afraid of what will come next year. I am hoping that after i get my RN and a job, that I will get back to great insurance coverage, but happy that we have coverage for everything that we need.
     
  13. caspi

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    This is true for us as well.
     
  14. KatieJane'smom

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    Do you get your supplies through a mail order company or the pharmacy?
     
  15. jcanolson

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    We can get 3 month supply through our local pharmacy and I can use the Apidra discount card to get the 3 month supply for $0. Different insurance, different rules I guess.
     
  16. goochgirl

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    Thank you all for your responces. I have limited computer access, so it takes me a while. I will check out the Apidra offer.
     
  17. Marie4Julia

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    You may also want to check into DME. I know some insurance cover strips and D supplies under DME at a lower (and sometimes NO) copay.
     
  18. bandmkolb

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    I am checking on this today. Should I ask the pharmacy or insurance provider?
     
  19. CAGrandma

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    And don't forget that every state has a program for families with children with chronic health conditions that will cover medical expenses that your regular health insurance doesn't (including copays). There are income guidelines of course, but the program is federally funded and state administered. In California it's called CCS - California Children's Services and is administered through the state dept of health.
     
  20. mmgirls

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    Insurance company should be able to give you a list of DME providers. Most of them will be mail order. very few "pharmacies" are also DME providers, you would have to ask them if the are.
     

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