Guest guest Posted December 21, 2005 Report Share Posted December 21, 2005 I recently got a letter from Medco, which handles my insurance company's prescription coverage. They are going to remove Celebrex from their formulary, which means that if I continue to take it, I'll have to pay $50 a month. First Bextra was taken away from me, and now Celebrex! I wish bureaucrats would stop messing with my medicine. I don't know what I can take. I tried salsalate, and I had lots of RA pain, and also stomach pain. I don't want to get another bleeding ulcer, which I did from OTC Aleve. I can't take MTX along with my Enbrel because it decreases my white blood cell count too much. My choices are getting fewer and fewer. Sue Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 21, 2005 Report Share Posted December 21, 2005 Sue, I feel you pain. I was using Bextra with NO problems...then it was gone. Unfortunately I can not take Celebrex due to Sulfa cross sensitivity. Now I am on Lodine XL and I have to take Nexium when I can get samples to protect my pouch(post-op weightloss lapband patient). When I can't get Nexium samples I try to take the OTC prilosec. I am serious thinking about buying my Meds in Mexico...I live in Texas so it might be worth the try. Toni > > I recently got a letter from Medco, which handles my insurance > company's prescription coverage. They are going to remove Celebrex from > their formulary, which means that if I continue to take it, I'll have > to pay $50 a month. > > First Bextra was taken away from me, and now Celebrex! I wish > bureaucrats would stop messing with my medicine. > > I don't know what I can take. I tried salsalate, and I had lots of RA > pain, and also stomach pain. I don't want to get another bleeding > ulcer, which I did from OTC Aleve. > > I can't take MTX along with my Enbrel because it decreases my white > blood cell count too much. > > My choices are getting fewer and fewer. > > Sue > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 21, 2005 Report Share Posted December 21, 2005 Toni, I would love to have my Bextra back. I was on a low dose and had no problems with it either. Also, I had hardly any pain. Celebrex doesn't work as well for me, but it works better than anything else I've tried. The salsalate was just useless. The OTC Prilosec is very expensive, too, as far as OTC meds go. If I lived near Mexico, I would be tempted to see if they still have Bextra. Sue On Wednesday, December 21, 2005, at 10:23 PM, Ms radar wrote: > > Sue, > > I feel you pain. I was using Bextra with NO problems...then it was > gone. Unfortunately I can not take Celebrex due to Sulfa cross > sensitivity. > > Now I am on Lodine XL and I have to take Nexium when I can get > samples to protect my pouch(post-op weightloss lapband patient). > When I can't get Nexium samples I try to take the OTC prilosec. > > I am serious thinking about buying my Meds in Mexico...I live in > Texas so it might be worth the try. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 22, 2005 Report Share Posted December 22, 2005 Marina, You can appeal that decision. Especially since you were on the drug and doing well before they discontinued it in their formulary. You can request to continue for continueity of care. I would iinclude in your appeal how long you have been on MTX and the fact that MTX alone is not doing the job so you need your Enbrel. REmind them that failure to get the proper care due to their change in the long run will cost them more money when you need even MORE expensive meds and possible surgury and other therapy. Did they discontinue all the other biologics too?The other option would be to go on Enbrel's patient assistance program. Or try to switch to another biologic. I can guess what has happened. They were getting Enbrel for their mail order pharmacy at a great discount...and that contract either ended or when renewed they were not able to get the great discount and decided it was too expensive for them to continue...so they are passing more of the cost on to the patient. Toni > > > > I recently got a letter from Medco, which handles my insurance > > company's prescription coverage. They are going to remove Celebrex > from > > their formulary, which means that if I continue to take it, I'll > have > > to pay $50 a month. > > > > First Bextra was taken away from me, and now Celebrex! I wish > > bureaucrats would stop messing with my medicine. > > > > I don't know what I can take. I tried salsalate, and I had lots of > RA > > pain, and also stomach pain. I don't want to get another bleeding > > ulcer, which I did from OTC Aleve. > > > > I can't take MTX along with my Enbrel because it decreases my > white > > blood cell count too much. > > > > My choices are getting fewer and fewer. > > > > Sue > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 22, 2005 Report Share Posted December 22, 2005 Oh, they had already done that with Enbrel. The co-pay for the top tier drugs is $50 a month. Enbrel is still a bargain for me, but I don't want to pay $50 for Celebrex, too. I am also on drugs for diabetes, migraines, bones, and cholesterol, so it all adds up to a lot. Sue On Thursday, December 22, 2005, at 10:02 AM, marina_troi wrote: > hear ya. My insurance company did the same thing to me, only with > Enbrel. They decided to remove Enbrel from their formulary, > therefore I have to pay the much higher premium. Their > suggestions? I should take methotrexate instead. It's still > formulary. Well, HHEEELLLOOOOO!!! If the idiots would look at the > list of meds, they would see I am already ON methotrexate. I agree, > the beaurocrats need to get their greedy noses out of the medical > business and leave medical management to the nurses and doctors who > actually KNOW what they are doing!!>.........Marina Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 22, 2005 Report Share Posted December 22, 2005 My insurance contracts with Medco to handle their prescription coverage. They don't handle the other parts of our coverage, so they would not have to pay for surgery or other therapy. Sue On Thursday, December 22, 2005, at 12:48 PM, Ms radar wrote: > REmind them that > failure to get the proper care due to their change in the long run > will cost them more money when you need even MORE expensive meds and > possible surgury and other therapy. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 22, 2005 Report Share Posted December 22, 2005 Thanks, Toni. I tried that. Didn't work. Granted, I pay $45 dollars a month now instead of $25. But, the fact that they can make that choice and try to tell me how my doctor should be ordering medications just burns me up!! Lately I haven't been taking the Enbrel. My rheumy took me off of it to see if the vasculitis would clear up. It started to, which had me happy and sad. Happy that it was clearing up, sad because it could be the Enbrel causing it and the Enbrel was helping the RA. But, it is getting worse again and I haven't been on the Enbrel for nearly 5 weeks now. So, I hope I can start it back up next week......Marina > > > > > > I recently got a letter from Medco, which handles my insurance > > > company's prescription coverage. They are going to remove > Celebrex > > from > > > their formulary, which means that if I continue to take it, I'll > > have > > > to pay $50 a month. > > > > > > First Bextra was taken away from me, and now Celebrex! I wish > > > bureaucrats would stop messing with my medicine. > > > > > > I don't know what I can take. I tried salsalate, and I had lots > of > > RA > > > pain, and also stomach pain. I don't want to get another bleeding > > > ulcer, which I did from OTC Aleve. > > > > > > I can't take MTX along with my Enbrel because it decreases my > > white > > > blood cell count too much. > > > > > > My choices are getting fewer and fewer. > > > > > > Sue > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 22, 2005 Report Share Posted December 22, 2005 Please check into co-pay assistance. I know that Humira and Enbrel have them..not sure about other drugs. Its worth a try. I know when I looked into it for Humira about six months ago I was told they would cover my $50 co-pay per month with a re-imbursement program. I had to pay first and then send in the reciept and they would send me a check. At first I was not happy with that...cause if I had the money to pay the co-pay I would not be asking for help. I was also concerned if I committed the money to the meds...how long was it going to take to get the check..cause around here the phone company and water company do not care and will cut you off in a heartbeat. Toni > > > hear ya. My insurance company did the same thing to me, only with > > Enbrel. They decided to remove Enbrel from their formulary, > > therefore I have to pay the much higher premium. Their > > suggestions? I should take methotrexate instead. It's still > > formulary. Well, HHEEELLLOOOOO!!! If the idiots would look at the > > list of meds, they would see I am already ON methotrexate. I agree, > > the beaurocrats need to get their greedy noses out of the medical > > business and leave medical management to the nurses and doctors who > > actually KNOW what they are doing!!>.........Marina > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 22, 2005 Report Share Posted December 22, 2005 If you sue them and you employer because of medical neglect caused by there decisons on what medical treatment and meds you can have access too. Toni > > > REmind them that > > failure to get the proper care due to their change in the long run > > will cost them more money when you need even MORE expensive meds and > > possible surgury and other therapy. > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 8, 2008 Report Share Posted November 8, 2008 That has been our experience as well. Pretty soon they'll cut their losses. Robyn > From: and Marcia Hinds <hindssite@...> > Subject: Insurance companies > barbkatsaros@..., > Date: Saturday, November 8, 2008, 6:07 AM > Barb, > > I have found over the years with insurance companies the > thing you have to > do is outlast them. They are trying to wear you down in > hopes that you will > go away. Kind of like our kids when they were little and > before Dr. G. > Don't let either of them win. I even got the insurance > company to pay for > our ABA specialist we flew in to Minnesota when was > little. Of course > I didn't have time to go after them for that until he > was somewhat better. > I wrote them over and over again for 6 months with no > success. ( Put > everything in writing.) Then I hired an attorney to write > one letter and > that was all it took. I guess they thought it was cheaper > to pay than face > legal action. Hope it works for you. > > Marcia > > > > Quote Link to comment Share on other sites More sharing options...
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