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Medications! Expensive!!

post #1 of 27
Thread Starter 
I went to the doctor the other day because I can't get rid of this sinus and respiratory thing that I have. It's been lingering since September 21st and last week I got hit with something else on top of it.

My sinuses are infected, and the infection is going to my chest too, so he put me on Biaxin XL. It's a medication that causes a gross rancid grapefruit taste in your mouth the entire time you're on it.

Anyway, he put me back on my inhalers. Both the rescue and steroid one. So I had to fill those too. I also needed my Synthoid (thyroid) and Celexa (depression).

I nearly passed out at the pharmacy! The bill came to just over $400.00. I have Blue Cross coverage that pays 80%, but it seems I've maxed it out and had to shoulder the entire cost. Ugh! The antibiotic alone for 10 days was almost $70! One of my puffers was $125.00!

No wonder people who don't have health insurance sometimes forgo getting medications refilled! The cost is simply outrageous!
post #2 of 27
That seems unusual! I thought that most insurance companies had an "out-of-pocket" maximum, or deductible, and once that was met, they pay 100%. You might want to check into that, because what you are describing just seems back wards! Oh yeah, Biaxin is the worst!!! I always thought it made my mouth have an awful metallic taste...but it sure works well for URIs!

I know what you mean about medications being exorbitantly priced. My Imitrex now comes in a generic, which with my insurance still cost $25.72 for 9 tablets. The price before insurance was $229.99 for 9 tablets. How much of that do you think is profit?
post #3 of 27
I spend close to $200 USD a month on my meds....it sucks, but I can't go without it! Several of those are name brand because there are no generics for them yet, the rest I take generic. (and that's close to $200 in copays...with insurance!) / I definitely feel your pain! It's rediculious how expensive medicine can be!

When my insurance runs out in a couple months I'm gonnna be screwed if I can't find another policy that isn't too expensive.

One thing you may want to try is seeing if your doctor can give you free samples of your prescriptions. I have two doctors (OBGYN and GI) that get tons of samples in constnatly, so they usually are able to give me free samples of the pill and my reflux medicine (If I were to get it from my pharmacy and pay my current copay, the pill is $30 and the reflux medicine is $50 ....so $80 a month. unfortunately the ones I use have no available generic, so that's not an option.) Most months they're able to give me samples, so that definitely helps out a lot! Maybe you can see if your doctor carries samples of your prescriptions too and can give you a few to save some $.
post #4 of 27
I'm so pleased the UK doesn't have the US health coverage
post #5 of 27
Quote:
Originally Posted by Rosiemac View Post
I'm so pleased the UK doesn't have the US health coverage
Ditto! I only have 2 years to go and then all my prescriptions will be $2.
post #6 of 27
Our family's prescription bill runs about $700 a month just for routine meds. That is the price with insurance helping, too. One of my meds alone would be around $5K a month if I paid full price, another around $900. My daughter is on a couple of scripts and my dh takes a blood pressure pill.

Yes, I'm scared about the future....
post #7 of 27
Quote:
Originally Posted by Natalie_ca View Post
I went to the doctor the other day because I can't get rid of this sinus and respiratory thing that I have. It's been lingering since September 21st and last week I got hit with something else on top of it.

My sinuses are infected, and the infection is going to my chest too, so he put me on Biaxin XL. It's a medication that causes a gross rancid grapefruit taste in your mouth the entire time you're on it.

Anyway, he put me back on my inhalers. Both the rescue and steroid one. So I had to fill those too. I also needed my Synthoid (thyroid) and Celexa (depression).

I nearly passed out at the pharmacy! The bill came to just over $400.00. I have Blue Cross coverage that pays 80%, but it seems I've maxed it out and had to shoulder the entire cost. Ugh! The antibiotic alone for 10 days was almost $70! One of my puffers was $125.00!

No wonder people who don't have health insurance sometimes forgo getting medications refilled! The cost is simply outrageous!
WTH? I also have BC/BS. I have NEVER ran into that problem.I take anywhere from 4-6 meds a month.They range in price of about $10-20 each with co-pay.My sons are ALWAYS on meds also.I have never ever had them tell me that. I would be calling your insurance company and seeing what the heck is going on.
As for expensive meds, I can relate.For 9 Amerge without my insurance is $319.00. With it, it is $20.
post #8 of 27
Quote:
Originally Posted by Rosiemac View Post
I'm so pleased the UK doesn't have the US health coverage
Quote:
Originally Posted by Yosemite View Post
Ditto! I only have 2 years to go and then all my prescriptions will be $2.

Natalie_ca doesn't live in the US. She lives in Canada.
post #9 of 27
But do they have to pay a monthly insurance like the US?
post #10 of 27
Quote:
Originally Posted by Rosiemac View Post
But do they have to pay a monthly insurance like the US?
No, it depends on your coverage. For example, my DH has awesome benefits with his job (dental, medical & full prescription) and he doesn't pay into it each month. Some companies you have to contribute each month for your insurance. And some jobs you get squat benefits (like mine) and it's really lucky if your spouse has some!! Unfortunately, DH's coverage runs out in the winter because he's off until spring, so we're not allowed to get sick during the winter. Seriously though if we did need scripts it depends entirely on the meds as to how much it would cost. The Canadian healthcare system doesn't cover prescriptions for most people, so that's why the costs can add up. We are very fortunate to not have to pay out of pocket for doctor's visits and hospital stays though.
post #11 of 27
Quote:
Originally Posted by pushylady View Post
The Canadian healthcare system doesn't cover prescriptions for most people, so that's why the costs can add up. We are very fortunate to not have to pay out of pocket for doctor's visits and hospital stays though.
Thats crazy!!
post #12 of 27
Quote:
Originally Posted by pushylady View Post
The Canadian healthcare system doesn't cover prescriptions for most people, so that's why the costs can add up. We are very fortunate to not have to pay out of pocket for doctor's visits and hospital stays though.
That's very similar to ours. It's £7.20 for a prescription, but if your out of work or on benefits you get it free, and Doctors and Hospital visits are free along with treatment such as any operations, physiotherapy etc..

I remember someone here posted a couple of years ago what the cost was for an operation and it was mad!. They couldn't believe it when i said we get operations for free
post #13 of 27
Quote:
Originally Posted by Rosiemac View Post
That's very similar to ours. It's £7.20 for a prescription, but if your out of work or on benefits you get it free, and Doctors and Hospital visits are free along with treatment such as any operations, physiotherapy etc..

I remember someone here posted a couple of years ago what the cost was for an operation and it was mad!. They couldn't believe it when i said we get operations for free
Coverage also varies from Province to Province Susan. My company insurance pays my prescriptions and hubby's pays his. Usually what happens is for my prescriptions I have to pay up front and then claim them. What my coverage doesn't pay is then covered by my husband's insurance as a co-payment and vice versa. Our dental insurance works the same way except the dentist bills the insurance company directly and they pay him. We just show up, get the work done and leave.
post #14 of 27
Quote:
Originally Posted by Rosiemac View Post
I'm so pleased the UK doesn't have the US health coverage
Same here. I can't imagine.
post #15 of 27
Quote:
Originally Posted by Yosemite View Post
Coverage also varies from Province to Province Susan. My company insurance pays my prescriptions and hubby's pays his. Usually what happens is for my prescriptions I have to pay up front and then claim them. What my coverage doesn't pay is then covered by my husband's insurance as a co-payment and vice versa. Our dental insurance works the same way except the dentist bills the insurance company directly and they pay him. We just show up, get the work done and leave.
A question..... what if your company doesnt cover your prescriptions?
post #16 of 27
iirc - Biaxin XL isn't cheap. It was probably two years ago, but if you can find an old thread of mine some people did recommend another antibiotic that didn't have the metallic taste side effect - and is probably cheaper. Just for future reference.


If I didn't have insurance I couldn't get meds. My local pharmacy overcharges for one I take. Name brand price should be around $2.50 per pill for a 5mg pill. They charge $2.55 for the generic. It totals up to around $460 - insurance covers all but $52 of that.
We still end up spending quite a bit on DH's allergy and asthma meds when all is said and done, though. Mostly because of the Advair.
post #17 of 27
Quote:
Originally Posted by Yosemite View Post
My company insurance pays my prescriptions and hubby's pays his.
Some companies do that here as well. My niece Pat's husband has a private health scheme at his job for them to use, which means instead of waiting 2-3 weeks for a hospital appointment with the NHS, they get seen within a couple of days at one of the private hospitals.

Where i'm working now at my friends place, they pay for our eye tests because we use computers
post #18 of 27
I think it's criminal that medicine is so expensive. I don't have insurance and my cholesterol medicine is to expensive for me each month. I have to get crestor until I get my levels down. Then I can get the generic cheap med. My Dr is helping me out with samples, and I am working my butt off with meds, diet and exercise so I can get the cheap stuff. I have to take synthroid every day but that is cheap.

The cost of health care and medicine is out of control. There are CEO's(in USA) of the pharm. companies getting rich at our expense and it's a crime.
post #19 of 27
Quote:
Originally Posted by Pami View Post
A question..... what if your company doesnt cover your prescriptions?
Here in Ontario, anyway, you would pay out of pocket. I don't have prescription coverage, so I pay out of pocket for the full amount. My mom has a lot of expensive prescriptions and it's one reason my dad cannot afford to retire. As long as he keeps his job, 80% of the prescriptions are covered. If he retires, they would have to pay for them, which would make it too much.

Yosemite mentions $2 prescriptions...so I'm guessing once you reach a certain age, the government fronts the bill?

Not sure if there are programs for those on Ontario Works (welfare), but I know Employment Insurance doesn't provide prescription coverage, nor does Disability Pension Benefits.
post #20 of 27
Thread Starter 
Quote:
Originally Posted by Pookie-poo View Post
That seems unusual! I thought that most insurance companies had an "out-of-pocket" maximum, or deductible, and once that was met, they pay 100%. You might want to check into that, because what you are describing just seems back wards!
My Blue Cross coverage is through work. They only pay up to a maximum of $500.00 per calendar year. We do have something in our Province called "Pharmacare" where after a certain amount (based on your income) the cost is paid 100% by the Province. However, my "certain amount" is almost $3,000.00 per year before Pharmacare kicks in.

I can't even claim my medications on my income tax because I don't meet the percentage overage of 3%.
post #21 of 27
Thread Starter 
Quote:
Originally Posted by Rosiemac View Post
But do they have to pay a monthly insurance like the US?
We don't pay insurance for medical. There is private insurance coverage that you can sign up for that will cover things like dental, prescriptions, physio, massage, but it's an optional insurance coverage usually through work, though you can pay for it yourself directly through Blue Cross.

I have my private insurance through Blue Cross through my work. There is a limit of how much they pay for things. Dental is $1,000.00 per calendar year, medications is $500.00 per calendar year, massage and physio are $450.00 each per calendar year. Orthotics is 80% coverage every 2 years.
post #22 of 27
Thread Starter 
Quote:
Originally Posted by zoeysmom View Post
Here in Ontario, anyway, you would pay out of pocket.

Same here if you don't have insurance.

I have Blue Net which allows me to get the prescription for the portion that I would pay instead of paying all up front and sending in the receipt to Blue Cross. However, Blue Net costs me an additional fee through my work. I pay it because I don't want to have to be out of pocket money and have to wait for it to be reimbursed.

Also, there are medications here that are not covered by any insurance at all. Earlier this year I was on an antibiotic (forget which one), but it wasn't covered under Blue Cross, or our Pharmacare program either. So I had to pay 100% of the cost of it myself despite having insurance which covered other medications I get.
post #23 of 27
Quote:
Originally Posted by Rosiemac View Post
That's very similar to ours. It's £7.20 for a prescription, but if your out of work or on benefits you get it free, and Doctors and Hospital visits are free along with treatment such as any operations, physiotherapy etc..

I remember someone here posted a couple of years ago what the cost was for an operation and it was mad!. They couldn't believe it when i said we get operations for free
I know with Seth's operation and all, it was over $40,000.00.And thankfully, BC/BS ate most of that cost
post #24 of 27
We had Blue Cross through DH's work. We are lucky we had no maximums, it was just 80%. His work just switched to Sunlife. We have no maximum on prescriptions it pays 80%. All basic dental is 100%, extensive dental is 50% capped at $2000 per person. My everyday prescriptions are just over $200 a month.
post #25 of 27
I dont have insurance and I cant afford to go to my old family doctor its 150 just to walk in the door let alone if they have to draw blood or give you a perscription anything like that its crazy. The only way I can get insurance is to buy it from work which its crap anyways and too expensive a month or get pregnant and get county medical insurance...Its horrible I cant call off work for being sick because if I call off and cant get to the doctors for a note I get written up. I just knock on wood that if I do get sick Tylenol or something along those lines (alcohol free due to probation) will work enough to kick it out of my system. Heaven forbid I get swine flu..My one manager whom I work with the most just was out of work because he got swine flu! Knock on wood I dont get sick within the next week!
post #26 of 27
Quote:
Originally Posted by Pami View Post
A question..... what if your company doesnt cover your prescriptions?
My husband's company would cover them for both of us. If we worked for a company that did not have those benefits, we would have to purchase private insurance for dental, drugs, physiotherapy.

In Canada (at least in Ontario - I don't know about the other provinces), when you reach 65 your drugs are covered. All you pay is a dispense fee of $2.
post #27 of 27
Thread Starter 
Quote:
Originally Posted by Yosemite View Post
In Canada (at least in Ontario - I don't know about the other provinces), when you reach 65 your drugs are covered. All you pay is a dispense fee of $2.
That is not the case in Manitoba. There is no senior discount for medications.
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