Reverse Sticker Shock on Fentanyl

In August, September, and October, I had reached some proverbial hole in my SS drug plan, and had to pay $360 or so for each of those month's Fentanyl Patches.  Was going broke in the process.  Based on how it worked last year, I was expecting to pay the same high price for November and December.

My regular CVS was out of it, so they sent me, after a phone call, to the other CVS in our small city to get it filled, one I never shop at.

So I waited, and when it was ready, I thought the guy said, "That will be seven hundred...".  All I heard was the "7" part and started freaking out.  He asked me what was wrong, and I said I can't pay over seven hundred.

He kind of laughed and said, not seven hundred, it's only $73.  I was stunned.  Asked him why, he said something about how I met some other Medicare out of pocket threshold, and for November and December it would be the 73 dollars.  I was so relieved, as I had to put away the $360 I thought I would need, so this saved me almost $290 this month.  Needless to say I was happy and relieved.

Good part, I recently signed up for a new Blue Cross supplement plan, and my total co-pays for all my meds starting in January will be around 51 dollars, for 4 meds.  My fentanyl will have a set and steady price all 12 months of the year at $15 bucks for 15 patches.  To me, that is a financial miracle of sorts.

The other good news, with me getting 100% Full VA disability and full VA Medical Care on top of the Medicare, the VA told me that they have to reimburse me for all co-pays, prescriptions, and any other medical expenses based on my prostate cancer, retro-active to October of 2009.  All I have to do is fill out a form with receipts and print outs from the pharmacy.  I am only guessing, but it could be as much as $10,000 or more.  Kind of stunned with this development.

None of this makes me feel any less in pain, doesn't slow down my cancer, but takes away a lot of the financial burden from the past, and into the future, for which I am most grateful.

David

 

Great !! Pleasant surprise to hear of anyone not being messed over $$wise!

David I can just imagine the look on the pharmacy guys face when you were proceeding to a full blown panic attack over $7.

I'm glad it is all working out and you'll never again have to worry about how to pay for your meds the last few months of the year!

Happy to read this David

UA

YAY!

Oh how I feel for you all in the US. I always get the Duragesic brand of fentanyl as well as all the other meds I am on and I pay nothing. Here in Scotland all prescription medicines are free. I just could not imagine having to pay what you do for meds. Seems unfair that you have to pay for being sick, at a time when you have less money coming in....l

Jane

Jane,

Here in the US, so much depends on whether you have private health insurance or not, I am on Medicare, with is US health insurance, usually associated with people of retirement age of 65 or higher. In my case, I was declared fully disabled at age 56, and was put on Medicare.

Now that I am approved for Veterans Disability, for my service in Viet Nam over 40 years ago, I now also get free full coverage health insurance through the VA.

I am fortunate in my situation, and thankful. There are many Americans with no insurance at all, which makes getting proper medical care difficult at base for those unfortunates.

With the newly implemented ACA (Affordable Care Act), hopefully there will be a low cost way for some of the millions of uninsured in this country.

I have many friends in the UK, Canada, and Australia, and most are pretty happy with the government based insurance programs. No system is perfect, of course.

But it's a real shame to be living in the richest country on earth, and have so many people unable to buy their needed medicines, or having to choose from buying food, paying rent, etc or having money to buy medications.

David