Re: insurance covering Carnitor?

[Guest guest]

> insurance covering Carnitor?

> It's only just occurred to me, that my " new " drug insurance coverage would

make

> Carnitor far less expensive to me, than the OTC I've been doing so far.

Yes, using the generic rx levocarnitine, we pay $5 a month. Real cost in our

pharmacy would be about $160 per month for my dose, which is not much lower

than the cost of brand-name Carnitor.

> 2) As to Carnitor, which I know is just the plain variant of carnitine,

not acetyl....is

> this likely to be approved by an insurer, or is it going to be difficult?

Anyone with

> experience either way, I'd like to hear about it. Despite my neuro doc's

general

> disinterest in this supplement (as I noted in an earlier post), I suspect

he will write a

> scrip, but probably won't defend it vigorously.

There should be no difficulty getting coverage for Carnitor. It has official

orphan drug status and is in most formularies. It was even on the " preferred

drug " list for my previous prescription plan.

> 3) Are there any issues about the efficacy of Carnitor vs. OTC carnitine?

I know

> one, namely that you cannot be as sure of what you're getting, with any

OTC. But is

> there anything else?

Not that I'm aware of. I don't know if purity of OTC products has improved,

but 10-15 years ago a Duke study of 12 OTC brands of L-carnitine found that

none contained the amount claimed on the label and some contained only

traces. YMMV.

Barbara

[Guest guest]

Do not know about the generic Carnitor as have not tried to get it yet (the mail

order screwed up last year and send myself and my son 9 months supply)--he does

not use it but uses Carniqgel.

Anyway, my stingy, does not pay for much and then very little insurance which is

Tricare (thru my husband) pays for the Carnitor at $9 for a months supply.

Doctor has to write out the amount for a month. Unfortunately I have to pay the

same for my diabetic supplies and insulin and each thing--lancets, test strips,

reservoir for insulin, tubing for insulin pump are all considered separate

things and have to pay 25% of the cost each month.

Janet Sample

insurance covering Carnitor?

It's only just occurred to me, that my " new " drug insurance coverage would

make Carnitor far less expensive to me, than the OTC I've been doing so far.

1) I can't recall, but wasn't there some discussion here about a possible new

prescription for ACETYL carnitine. Does anyone know any more on this point?

2) As to Carnitor, which I know is just the plain variant of carnitine, not

acetyl....is this likely to be approved by an insurer, or is it going to be

difficult? Anyone with experience either way, I'd like to hear about it. Despite

my neuro doc's general disinterest in this supplement (as I noted in an earlier

post), I suspect he will write a scrip, but probably won't defend it vigorously.

3) Are there any issues about the efficacy of Carnitor vs. OTC carnitine? I

know one, namely that you cannot be as sure of what you're getting, with any

OTC. But is there anything else?

Steve D.

[Guest guest]

> It's only just occurred to me, that my " new " drug insurance

> coverage would make Carnitor far less expensive to me, than the OTC

> I've been doing so far.

This is an important point, since many of us are taking supplements

that may or may not have a prescription " equivalent " (see my notes

below about Carnitor and OTC carnitine), it might seem that OTC

should always be cheaper. But it really depends on the supplement

and the store. I try to buy things online to save money, and also my

insurance company has a website where you can cost medications before

you are prescribed them.

> 1) I can't recall, but wasn't there some discussion here about a

> possible new prescription for ACETYL carnitine. Does anyone know

> any more on this point?

I'd be interested in that too...

> 2) As to Carnitor, which I know is just the plain variant of

carnitine, not acetyl....

This is sort of right - it's not acetyl, but Carnitor is what is

called a " self-salt " of carnitine - that is, the carnitine isn't

bound to a different group, like it would be in carnitine tartrate

for example. This makes it important for people to treat Carnitor

and its *exact* equivalents differently than OTC carnitine

supplements (they all have some other group attached to the

carnitine). I had taken OTC carnitine, which didn't do anything for

me, but Carnitor gave me severe side effects (definitely YMMV).

> is this likely to be approved by an insurer, or is it going to be

> difficult? Anyone with experience either way, I'd like to hear

> about it. Despite my neuro doc's general disinterest in this

> supplement (as I noted in an earlier post), I suspect he will write

> a scrip, but probably won't defend it vigorously.

I didn't have a problem getting Carnitor approved. Certainly getting

an OTC supplement approved as a covered medication is quite a battle,

even with Tishcon CoQ10 which has Orphan Drug status.

> 3) Are there any issues about the efficacy of Carnitor vs. OTC

> carnitine?

As I said, they are actually a bit different, although the point of

both of them is to get carnitine to your body. I noted my experience

above, but I think you are looking for a different assessment

> I know one, namely that you cannot be as sure of what you're

> getting, with any OTC. But is there anything else?

As I noted, they are a bit different inherently, but not

different " active ingredients " . For example, Vitamin C is ascorbic

acid, but usually is with calcium (calcium ascorbate) or esterified

( " Ester C " which is supposed to work better). But it is still

generally " Vitamin C " .

Hope this makes sense...

Take care,

RH

[Guest guest]

> Date: Thu, 08 Sep 2005 13:58:32 -0000

>

> Subject: Re: insurance covering Carnitor?

>

>

> > It's only just occurred to me, that my " new " drug insurance

> > coverage would make Carnitor far less expensive to me, than the OTC

> > I've been doing so far.

>

> This is an important point, since many of us are taking supplements

> that may or may not have a prescription " equivalent " (see my notes

> below about Carnitor and OTC carnitine), it might seem that OTC

> should always be cheaper. But it really depends on the supplement

> and the store. I try to buy things online to save money, and also my

> insurance company has a website where you can cost medications before

> you are prescribed them.

[...]

> Take care,

> RH

It's true that I assumed OTC would be cheaper than the actual cost of

Carnitor, and I'm pretty sure it is, considering the wide variety of prices

and the careful comparative shopping I've done online.

But I was really referring to the price of Carnitor TO ME, namely the amount

of my insurance co-pay, paid once each month for as big a bottle as I can

get my doc to prescribe. When I was upgraded recently on MassHealth

(Massachusetts' version of Medicaid) plans, from " Free Care " (which actually

is the most primitive of safety nets) to " Essential " (which is only a slight

cut above), I did find one huge surprise. All prescribed meds (from the

formulary or what I can get " prior approved " ) cost me $1 ($3 for name

brand). This seemed absurdly generous to me, struggling so mightily for

years to get any health care at all, and any recognition of my condition

from the federal government. I honestly couldn't believe it until I really

paid this once.

So for me, at least, prescribed $3 Carnitor IS going to be cheaper, assuming

I can get it approved. For some insane reason, I've had no success in

locating the MassHealth formulary online.

Unfortunately, this prescription benefit of MassHealth is ending this year.

All enrollees will be forced to choose one of the new Medicare drug plans,

which is one of the goofiest most complicated over-hyped pieces of

legislation in a while.

BTW my recent success in getting federal disability will make me eligible

for MassHealth Standard, which is the best of the plans. Too bad, I'm

expecting that my new-found SSDI income will also bump me into having to pay

a premium for this. Hopefully, the upgrade will be worth it.

I'm assuming that many others here are periodically stressed out by all the

complexities and demands of dealing with compensation for treatment, medical

equipment, transport, etc. There is probably (hopefully?) an entire industry

devoted to helping people just figure all this out, yes?

Steve D.

[Guest guest]

Steve

Yes, there is an entire industry to help people deal with insurance

issues if you are lucky to be authorized for it. In Michigan, it is

called medical case management, but like everything else there is good

and bad. My insurance pays for the service for chronic conditions.

I'm glad your insurance is improving.

laurie

> > Date: Thu, 08 Sep 2005 13:58:32 -0000

> >

> > Subject: Re: insurance covering Carnitor?

> >

> >

> > > It's only just occurred to me, that my " new " drug insurance

> > > coverage would make Carnitor far less expensive to me, than the OTC

> > > I've been doing so far.

> >

> > This is an important point, since many of us are taking supplements

> > that may or may not have a prescription " equivalent " (see my notes

> > below about Carnitor and OTC carnitine), it might seem that OTC

> > should always be cheaper. But it really depends on the supplement

> > and the store. I try to buy things online to save money, and also my

> > insurance company has a website where you can cost medications before

> > you are prescribed them.

> [...]

> > Take care,

> > RH

>

> It's true that I assumed OTC would be cheaper than the actual cost of

> Carnitor, and I'm pretty sure it is, considering the wide variety of prices

> and the careful comparative shopping I've done online.

>

> But I was really referring to the price of Carnitor TO ME, namely the amount

> of my insurance co-pay, paid once each month for as big a bottle as I can

> get my doc to prescribe. When I was upgraded recently on MassHealth

> (Massachusetts' version of Medicaid) plans, from " Free Care " (which actually

> is the most primitive of safety nets) to " Essential " (which is only a slight

> cut above), I did find one huge surprise. All prescribed meds (from the

> formulary or what I can get " prior approved " ) cost me $1 ($3 for name

> brand). This seemed absurdly generous to me, struggling so mightily for

> years to get any health care at all, and any recognition of my condition

> from the federal government. I honestly couldn't believe it until I really

> paid this once.

>

> So for me, at least, prescribed $3 Carnitor IS going to be cheaper, assuming

> I can get it approved. For some insane reason, I've had no success in

> locating the MassHealth formulary online.

>

> Unfortunately, this prescription benefit of MassHealth is ending this year.

> All enrollees will be forced to choose one of the new Medicare drug plans,

> which is one of the goofiest most complicated over-hyped pieces of

> legislation in a while.

>

> BTW my recent success in getting federal disability will make me eligible

> for MassHealth Standard, which is the best of the plans. Too bad, I'm

> expecting that my new-found SSDI income will also bump me into having to pay

> a premium for this. Hopefully, the upgrade will be worth it.

>

> I'm assuming that many others here are periodically stressed out by all the

> complexities and demands of dealing with compensation for treatment, medical

> equipment, transport, etc. There is probably (hopefully?) an entire industry

> devoted to helping people just figure all this out, yes?

>

> Steve D.

>

>

>

>

> Medical advice, information, opinions, data and statements contained herein

are not necessarily those of the list moderators. The author of this e mail is

entirely responsible for its content. List members are reminded of their

responsibility to evaluate the content of the postings and consult with their

physicians regarding changes in their own treatment.

>

> Personal attacks are not permitted on the list and anyone who sends one is

automatically moderated or removed depending on the severity of the attack.

>

>

[Guest guest]

http://www.zixcorp.com/erxinfo/new_features_mass_formularies.html

Steve wrote:

>> Date: Thu, 08 Sep 2005 13:58:32 -0000

>>

>>Subject: Re: insurance covering Carnitor?

>>

>>

>>

>>

>>>It's only just occurred to me, that my " new " drug insurance

>>>coverage would make Carnitor far less expensive to me, than the OTC

>>>I've been doing so far.

>>>

>>>

>>This is an important point, since many of us are taking supplements

>>that may or may not have a prescription " equivalent " (see my notes

>>below about Carnitor and OTC carnitine), it might seem that OTC

>>should always be cheaper. But it really depends on the supplement

>>and the store. I try to buy things online to save money, and also my

>>insurance company has a website where you can cost medications before

>>you are prescribed them.

>>

>>

> [...]

>

>

>>Take care,

>>RH

>>

>>

>

>It's true that I assumed OTC would be cheaper than the actual cost of

>Carnitor, and I'm pretty sure it is, considering the wide variety of prices

>and the careful comparative shopping I've done online.

>

>But I was really referring to the price of Carnitor TO ME, namely the amount

>of my insurance co-pay, paid once each month for as big a bottle as I can

>get my doc to prescribe. When I was upgraded recently on MassHealth

>(Massachusetts' version of Medicaid) plans, from " Free Care " (which actually

>is the most primitive of safety nets) to " Essential " (which is only a slight

>cut above), I did find one huge surprise. All prescribed meds (from the

>formulary or what I can get " prior approved " ) cost me $1 ($3 for name

>brand). This seemed absurdly generous to me, struggling so mightily for

>years to get any health care at all, and any recognition of my condition

>from the federal government. I honestly couldn't believe it until I really

>paid this once.

>

>So for me, at least, prescribed $3 Carnitor IS going to be cheaper, assuming

>I can get it approved. For some insane reason, I've had no success in

>locating the MassHealth formulary online.

>

>Unfortunately, this prescription benefit of MassHealth is ending this year.

>All enrollees will be forced to choose one of the new Medicare drug plans,

>which is one of the goofiest most complicated over-hyped pieces of

>legislation in a while.

>

>BTW my recent success in getting federal disability will make me eligible

>for MassHealth Standard, which is the best of the plans. Too bad, I'm

>expecting that my new-found SSDI income will also bump me into having to pay

>a premium for this. Hopefully, the upgrade will be worth it.

>

>I'm assuming that many others here are periodically stressed out by all the

>complexities and demands of dealing with compensation for treatment, medical

>equipment, transport, etc. There is probably (hopefully?) an entire industry

>devoted to helping people just figure all this out, yes?

>

>Steve D.

>

>

>

>

>Medical advice, information, opinions, data and statements contained herein are

not necessarily those of the list moderators. The author of this e mail is

entirely responsible for its content. List members are reminded of their

responsibility to evaluate the content of the postings and consult with their

physicians regarding changes in their own treatment.

>

>Personal attacks are not permitted on the list and anyone who sends one is

automatically moderated or removed depending on the severity of the attack.

>

>

[Guest guest]

I did of course mean the price after any discount or insurance, who

cares how much it really costs, unless one has to pay that

Here's a link to MassHealth's equivalent of a drug formulary - they

call it a " drug list " and note it isn't as limiting as a formulary:

http://www.mass.gov/portal/site/massgovportal/menuitem.307e4dfc1e5731c

14db4a11030468a0c/?

pageID=eohhs2terminal&L=4&L0=Home&L1=Provider&L2=Guidelines+for+Clinic

al+Treatment&L3=MassHealth+Drug+List&sid=Eeohhs2&b=terminalcontent&f=m

asshealth_provider_pharmacy_druglist_intro&csid=Eeohhs2

Note that you may have to copy that piece by piece since it is a long

link. The note on Carnitor says that you need authorization because

there are generic equivalents (as others have noted).

It might be easier to type " masshealth drug list " into Google, and

the first link that appears is the right one...

You have six weeks after October 15, 2005 to decide on which coverage

you want, that's the date they list the formularies for the new

plans, otherwise they will randomly assign you to a plan.

Take care,

RH

> > > It's only just occurred to me, that my " new " drug insurance

> > > coverage would make Carnitor far less expensive to me, than the

OTC

> > > I've been doing so far.

> >

> > This is an important point, since many of us are taking

supplements

> > that may or may not have a prescription " equivalent " (see my notes

> > below about Carnitor and OTC carnitine), it might seem that OTC

> > should always be cheaper. But it really depends on the supplement

> > and the store. I try to buy things online to save money, and

also my

> > insurance company has a website where you can cost medications

before

> > you are prescribed them.

> [...]

> > Take care,

> > RH

>

> It's true that I assumed OTC would be cheaper than the actual cost

of

> Carnitor, and I'm pretty sure it is, considering the wide variety

of prices

> and the careful comparative shopping I've done online.

>

> But I was really referring to the price of Carnitor TO ME, namely

the amount

> of my insurance co-pay, paid once each month for as big a bottle as

I can

> get my doc to prescribe. When I was upgraded recently on MassHealth

> (Massachusetts' version of Medicaid) plans, from " Free Care " (which

actually

> is the most primitive of safety nets) to " Essential " (which is only

a slight

> cut above), I did find one huge surprise. All prescribed meds (from

the

> formulary or what I can get " prior approved " ) cost me $1 ($3 for

name

> brand). This seemed absurdly generous to me, struggling so mightily

for

> years to get any health care at all, and any recognition of my

condition

> from the federal government. I honestly couldn't believe it until I

really

> paid this once.

>

> So for me, at least, prescribed $3 Carnitor IS going to be cheaper,

assuming

> I can get it approved. For some insane reason, I've had no success

in

> locating the MassHealth formulary online.

>

> Unfortunately, this prescription benefit of MassHealth is ending

this year.

> All enrollees will be forced to choose one of the new Medicare drug

plans,

> which is one of the goofiest most complicated over-hyped pieces of

> legislation in a while.

>

> BTW my recent success in getting federal disability will make me

eligible

> for MassHealth Standard, which is the best of the plans. Too bad,

I'm

> expecting that my new-found SSDI income will also bump me into

having to pay

> a premium for this. Hopefully, the upgrade will be worth it.

>

> I'm assuming that many others here are periodically stressed out by

all the

> complexities and demands of dealing with compensation for

treatment, medical

> equipment, transport, etc. There is probably (hopefully?) an entire

industry

> devoted to helping people just figure all this out, yes?

>

> Steve D.