My old insurance covered everything but self-administered injections. Now they changed our prescription policy, and they don’t want to cover my Saphris or Vraylar. Not sure what to do…
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Get your doctor to write a note saying you’ve tried so many other meds, and you need these ones.
That is what we are going to try, but no guarantees. We had to put up a major fight to get my migraine meds. Sucks!
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I hope you get the meds you need. Insurance can be frustrating at times
Yeah, really! I have never had issues except with my injectable blood thinners, so this is new to me.
can’t you switch your insurance to one that will cover it? i guess it’s possible there’s not an insurance policy for every drug out there, though.
i switched drugs when my latuda wasn’t covered by my new insurance. which i know you can’t necessarily do, though. it worked out great in my case, cause latuda was over a grand per month and gave me anxiety anyway, and went to the much cheaper and better for me, risperidone.
Yeah, both my Saphris and the Vraylar are over a grand each. That’s why they don’t want to cover it. They have added a $1,000 limit to meds.
I can’t switch insurance. We only have one option through my husband’s job.
I’m on latuda which is like $1300 a month. My pdoc said if my insurance wouldn’t pay for it she would provide me with samples. Perhaps you can ask your pdoc if they can do such a thing for you.
If you’re in the states, are on SSDI, don’t you also have Medicare? I get a program called Extra help, all my meds cost $3.40, no matter what they actually cost. Look into it, you may need to contact your county social services to ask though. I get it even with private insurance also, so definitely ask.
I’m on SSDI, but make too much to qualify. I wish I did!
that’s for sure especially when you are faced with a choice which insurance is better
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I do qualify for medicare, but it’s always been cheaper to go with my husband’s insurance. Now, I’m not so sure.
Unfortunately one is not likely to qualify for extra help if they are married and the spouse is making decend money working. You have to be low income to qualify for the extra help.
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I would need 60 tablets a month. I don’t know if she can do that…
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https://www.allergan.com/patient-assistance-programs
The drug company allergan has a patient assistance program for both saphris and vraylar. You are the type of person that may qualify because your insurance won’t cover these drugs. If approved they will donate the medication to you for free. Sometimes with patient assistance programs your income can be higher than you think because the medication is so expensive. I would encourage you to apply.
Wow! Thanks! That is REALLY helpful!!! I’ll definitely look into it.
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I get the extra help even with being married and hubby makes 20 an hour. But we have 3 kids, total with his income and my SSDI we make 52k a year. So maybe cause I make under 900 a month SSDI that qualifies me?
Maybe I’m wrong and you dont know until you apply. I’ve seen the income limits for extra help and they are not very high. Being married and having a spouse’s income works against you. However having dependents or kids can work in your favor.
Yep. Often they increase the amount if you have x or y many dependents. We don’t qualify for diddly squat, but hubby’s insurance was great, once upon a time. I can get MRIs and Xrays, etc. without any pre-certification, can see specialists without a referral, and pay the same for a specialist as I do for a family doctor. Hospital visits are covered at 100%, and so are outpatient surgeries.
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