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Medication Prices....Medicare vs Company Insurance

Posted by covidstinks2023 @covidstinks2023, Sep 5 5:17pm

Precious Folks, Someone please help me understand why Company paid insurance for medications are so much cheaper than Medicare or a Medicare sponsored insurance on the newer meds.

My Neurologist wants me on a migraine preventative called Qulipta. It was a non-formulary medication and so she filed with my insurance and the price for a month's supply is $1,445 for 30 tablets.

She then tried Nurtec as a preventative for me writing it for one tablet every other day for 16 tablets. It was also a non-formulary medication. $529 for 16 tablets. A friend of mine with company insurance gets theirs for free.

Being on Medicare, I cannot get pharmaceutical discounts online because Medicare is government supported. While some of my other medications are free (older meds) I am blessed and very grateful.

The pharmacy I use tries every discount they can for me and we even try Goodrx and another discount company. I have looked online too. I know newer meds are more expensive. I am looking into finding a better medication plan when it's time to make changes this year.

Thank you and God Bless You!

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tsch | @tsch | Sep 5 7:49pm

Drug makers often have discounted meds for lower income people, check out this as a possibility. If you have Part D or an advantage plan, are you using a preferred pharmacy?

REPLY
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judimahoney | @judimahoney | Sep 5 9:33pm

@covidstinks2023
Hi:
I have trouble with drug prices too, so one of my Docs suggested I go to a compounding pharmacy. I do save money. Hope you have one in your area.

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1 reply
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Mentor
Ginger, Volunteer Mentor | @gingerw | Sep 6 11:53am

@covidstinks2023 Do you have Medicare Part D, which is the drug benefit plan? I use Humana and have been for many years. There is an annual cap to be charged to you, about $2500. For me, I use that in the first month of every year due to my co-pay for chemo drug. After that, everything is covered. Of course you need to use the medications listed in their formulary. But believe me, seeing that I am on 12 different Rx drugs, it has been a game-changer for me!
Ginger

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1 reply
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tsch | @tsch | Sep 6 2:44pm

Some towns and states have drug programs too to help with costs. Get info from social services depts. Some people find lower prices in Canada too.

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1 reply
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covidstinks2023 | @covidstinks2023 | Sep 6 8:37pm
In reply to @tsch "Some towns and states have drug programs too to help with costs. Get info from social..." + (show)
Profile picture for tsch @tsch

Some towns and states have drug programs too to help with costs. Get info from social services depts. Some people find lower prices in Canada too.

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@tsch Thank you so much! Blessings & Prayers....

REPLY
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covidstinks2023 | @covidstinks2023 | Sep 6 8:38pm
In reply to @gingerw "@covidstinks2023 Do you have Medicare Part D, which is the drug benefit plan? I use Humana..." + (show)
Profile picture for Ginger, Volunteer Mentor @gingerw

@covidstinks2023 Do you have Medicare Part D, which is the drug benefit plan? I use Humana and have been for many years. There is an annual cap to be charged to you, about $2500. For me, I use that in the first month of every year due to my co-pay for chemo drug. After that, everything is covered. Of course you need to use the medications listed in their formulary. But believe me, seeing that I am on 12 different Rx drugs, it has been a game-changer for me!
Ginger

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@gingerw, TY. I"ll check on this. Blessings & Prayers....

REPLY
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covidstinks2023 | @covidstinks2023 | Sep 6 8:39pm
In reply to @judimahoney "@covidstinks2023 Hi: I have trouble with drug prices too, so one of my Docs suggested I..." + (show)
Profile picture for judimahoney @judimahoney

@covidstinks2023
Hi:
I have trouble with drug prices too, so one of my Docs suggested I go to a compounding pharmacy. I do save money. Hope you have one in your area.

Jump to this post

@judimahoney Thank you. I do! Blessings & Prayers.....

REPLY
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