Jan 172005

I was getting my Rebif filled tomorrow when I get a call from Wallgreens Specialty Pharmacy with my new co-pay. I thought she was kidding when she came back with $281.88! I said I would call the insurance company and find out what the problem was with the $62.50/month. Apparently in some non-existent fine print my employer changed it so “specialty” medications (read the expensive ones) have a 20% co-pay, even through mail order. So tomorrow I get to write a very persuasive essay to the head of HR to get this issue resolved, which probably means getting a new job. Best case what they did was extremely unethical, sadly it doesn’t surprise me too much! 🙁

 Posted by at 8:51 pm

  3 Responses to “My Damn Employer”

  1. Holy smokes! I thought that most formularies have the ABC/R drugs listed. Have them check this ASAP because it sounds like an oversight to me.

  2. Oh, they are aware of what they are doing. The drugs are listed on the formulary. Last year we were forced to use the mail order system, which was fine. However, since the drug is listed in the formulary we should have been able to get a 3 months supply for our copay. Although there was nothing prohibiting that in the system, we were never allowed to do so. Fine. $25 per month for a $1500 per month drug is okay. Then we are told the copay is going up to $63.50 per month, fine, we get prepared for that, and move forward. NOTHING we received from his company telling us about the new policy prepared us for this. We pay a lot of money for the policy, and I SERIOUSLY wonder if they contribute ANYTHING toward the insurance. Which is fine, but come on, keeping this silent, not letting us figure out what to do????

    This is very wrong, and although I don’t like to use this word, it is very discriminatory. For over 6 years we were the ones who NEVER used this policy. We paid out the nose for insurance for a rainy day. I understand how this works. The one’s who don’t use it, make it worth while from the insurance company perspective, for those who do use the policy. Now the rain is pouring and they want to take away the umbrella.

    $281.88 is a freaking car payment!

  3. I’m not surprised. I also have a 20% copay on my Copaxone, which works out to about $740 every three months. I guess it’s better than paying 100%, but it’s not as nice as $25 for the other non-generic non-specialty drug that I take. The sick part is that if I switch to Tysabri (assuming Aetna is approving use of Tysabri) it will be covered under our medical insurance, rather than our prescription insurance, which means it will likely cost us a lot less out of pocket. Crazy.

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