Non-formulary

Phantom Pain
Phantom Pain Posts: 9,876
edited April 2008 in All Encompassing Trip
I hate Insurance,Prescription coverage

I had been taking Zyrtec 10mg for awhile and now it went OTC

So, the Dr. switched my med to a new Prescription Xyzal 5mg

It's "Covered" I guess you would say on my Prescription plan as Non-Formulary which means I pay $50 for a 3 month supply !!

Sad part is I work for the Company that fills my Prescriptions

:(
My drinking team has a hockey problem

The ONLY thing better than a glass of beer is tea with Miss McGill



A protuberance of flesh above the waistband of a tight pair of trousers
Post edited by Unknown User on

Comments

  • Stone Is God
    Stone Is God Posts: 1,331
    Fuck insurance companies. All they do is take your money and then slash your benefits then increase your co-pays.
    I'll ride the wave where it takes me.
  • Phantom Pain
    Phantom Pain Posts: 9,876
    Stone Is God wrote:
    Fuck insurance companies. All they do is take your money and then slash your benefits then increase your co-pays.

    Exactly !!

    My insurance has gone up and up every fuckin year since I've been with this company

    I love how they dictate what drugs I can take and strangle people with higher co-pays if you take a drug they dont wanna pay for
    My drinking team has a hockey problem

    The ONLY thing better than a glass of beer is tea with Miss McGill



    A protuberance of flesh above the waistband of a tight pair of trousers
  • Zanne
    Zanne Posts: 899
    Phantom Pain wrote:
    I hate Insurance,Prescription coverage

    I had been taking Zyrtec 10mg for awhile and now it went OTC

    So, the Dr. switched my med to a new Prescription Xyzal 5mg

    It's "Covered" I guess you would say on my Prescription plan as Non-Formulary which means I pay $50 for a 3 month supply !!

    Sad part is I work for the Company that fills my Prescriptions

    :(


    You can get 60 Zyrtec at the overpriced Walgreens near you for 20.00. If it costs less for an effective OTC med than a new RX med, why would you bother getting the RX med?

    The insurances are sure full of shit, but this is just common sense on your part to go for the 20.00 OTC med.

    Saves your doctor alot of BS too, trust me, I'm a medical office manager and I do all our Prior Auth's (grrrrrrr)

    Peace
    Just me
  • Riverrunner
    Riverrunner Posts: 2,419
    Zanne wrote:
    You can get 60 Zyrtec at the overpriced Walgreens near you for 20.00. If it costs less for an effective OTC med than a new RX med, why would you bother getting the RX med?

    The insurances are sure full of shit, but this is just common sense on your part to go for the 20.00 OTC med.

    Saves your doctor alot of BS too, trust me, I'm a medical office manager and I do all our Prior Auth's (grrrrrrr)

    Peace

    My husband was on Zyrtec D. With our plan which was $70.00 for a 3mos. supply, we will be paying more per pill with it OTC. And that was at the Walgreens sale price, which we can't get because no matter how soon you get there after the sale bill comes out they say they "are out." If I remember it was a lot less than 60 pills for $20.00 at Wal-Greens - not even a mos. supply.
    The greatness of a nation and its moral progress can be judged by the way it treats its animals. Ghandi
  • Phantom Pain
    Phantom Pain Posts: 9,876
    Zanne wrote:
    You can get 60 Zyrtec at the overpriced Walgreens near you for 20.00. If it costs less for an effective OTC med than a new RX med, why would you bother getting the RX med?

    The insurances are sure full of shit, but this is just common sense on your part to go for the 20.00 OTC med.

    Saves your doctor alot of BS too, trust me, I'm a medical office manager and I do all our Prior Auth's (grrrrrrr)

    Peace

    Honestly I didn't check around for the OTC prices

    I will now though

    Yeah, my Allergist said he would probably be hearing from my plan at some point but they just boned me and raised my co-pay

    It's such Bullshit the way the "System" works
    My drinking team has a hockey problem

    The ONLY thing better than a glass of beer is tea with Miss McGill



    A protuberance of flesh above the waistband of a tight pair of trousers
  • Phantom Pain
    Phantom Pain Posts: 9,876
    Just for the hell of it I went to their website


    http://www.walgreens.com/search/search_results.jsp?_dyncharset=ASCII&term=zyrtec

    $29.99 for 45ct
    My drinking team has a hockey problem

    The ONLY thing better than a glass of beer is tea with Miss McGill



    A protuberance of flesh above the waistband of a tight pair of trousers
  • _Crazy_Mary_
    _Crazy_Mary_ Posts: 1,299
    Insurance sucks! I went to the gynie the other day and out-of-pocket the visit cost me $112. That's without insurance. Why would anybody pay $300-$750 month for insurance when one visit a year costs $112? I don't get it.
    I really screwed that up. I really Schruted it.
  • Zanne
    Zanne Posts: 899
    Phantom Pain wrote:
    Just for the hell of it I went to their website


    http://www.walgreens.com/search/search_results.jsp?_dyncharset=ASCII&term=zyrtec

    $29.99 for 45ct

    Sorry, I know there are diff prices per online and different Walgreens locations.. I was quoting one here in IL that is on my way to work and they have it on their billboard as 19.99 for 60 count.

    Peace and Love
    Just me
  • know1
    know1 Posts: 6,801
    Phantom Pain wrote:
    I hate Insurance,Prescription coverage

    I had been taking Zyrtec 10mg for awhile and now it went OTC

    So, the Dr. switched my med to a new Prescription Xyzal 5mg

    It's "Covered" I guess you would say on my Prescription plan as Non-Formulary which means I pay $50 for a 3 month supply !!

    Sad part is I work for the Company that fills my Prescriptions

    :(

    Why don't you just take the OTC?
    The only people we should try to get even with...
    ...are those who've helped us.

    Right 'round the corner could be bigger than ourselves.
  • libragirl
    libragirl Posts: 4,632
    I hate dealing with insurance companies. I work for a small nonprofit so we are constantly changing health insurers. I can't keep everything straight.
    These cuts are leaving creases. Trace the scars to fit the pieces, to tell the story, you don't need to say a word.
  • Phantom Pain
    Phantom Pain Posts: 9,876
    know1 wrote:
    Why don't you just take the OTC?

    The price basically

    I switched meds thinking this new one would be covered on my insurance

    Usually its $20 for a 3 month supply but they fucked me and said the new drug is Non-Formulary after it was filled

    Cheapest I saw for OTC Zyrtec was $26.99 for 45 tabs
    My drinking team has a hockey problem

    The ONLY thing better than a glass of beer is tea with Miss McGill



    A protuberance of flesh above the waistband of a tight pair of trousers
  • Indian Summer
    Indian Summer Posts: 2,296
    _Crazy_Mary_ wrote:
    Insurance sucks! I went to the gynie the other day and out-of-pocket the visit cost me $112. That's without insurance. Why would anybody pay $300-$750 month for insurance when one visit a year costs $112? I don't get it.


    What if you were diagnosed with something serious from that $112 visit, and it required surgery, or hospitalization? Would you be able to fork out the thousands to take care of all that?

    I used to think like you, until a few serious health conditions came up with me (I'm battling one now in fact). And insurance has helped me out a ton. Had a $18,000 surgery, that I only had to pay 200 bucks for. Tons of office visits, that I've only had to pay 10 dollar co-pays for.

    I hope nothing happens to you, but I'd advise you to get some sort of minimal health coverage at the least.
    "It's all happening"
  • cat72
    cat72 Oxford, MA Posts: 2,993
    I was taking zantac before it went otc. My pharmacist recomended that my doc write the script for the generic. If they write for the name brand the insurance company wont pay for it. By writing it for the generic the insurance pays. I was always taking the generic, but according to state law they have to fill generic unless the doc specifically states name brand only. Don't know if this will help you?
  • Zanne
    Zanne Posts: 899
    cat72 wrote:
    I was taking zantac before it went otc. My pharmacist recomended that my doc write the script for the generic. If they write for the name brand the insurance company wont pay for it. By writing it for the generic the insurance pays. I was always taking the generic, but according to state law they have to fill generic unless the doc specifically states name brand only. Don't know if this will help you?


    Usually during the first year the price of a generic med is as high as the name brand. This applies to Rx only meds, not when they go OTC, however for the insured it usually does help lower the copay. Uninsured get really screwed.

    Shop around for your meds, even if you have insurance. Walmart and Target pharmacies have been running the $4/month generic programs for over a year now. A lot of meds are available at that price for a full month's supply, which is often lower than the amount you pay as a copay for the same generic when you present with insurance. Crazy.
    Just me
  • cat72
    cat72 Oxford, MA Posts: 2,993
    Zanne wrote:
    Usually during the first year the price of a generic med is as high as the name brand. This applies to Rx only meds, not when they go OTC, however for the insured it usually does help lower the copay. Uninsured get really screwed.

    Shop around for your meds, even if you have insurance. Walmart and Target pharmacies have been running the $4/month generic programs for over a year now. A lot of meds are available at that price for a full month's supply, which is often lower than the amount you pay as a copay for the same generic when you present with insurance. Crazy.

    I get my generic scripts for 5.00 a month
  • _Crazy_Mary_
    _Crazy_Mary_ Posts: 1,299
    Indian Summer wrote:
    What if you were diagnosed with something serious from that $112 visit, and it required surgery, or hospitalization? Would you be able to fork out the thousands to take care of all that?

    I used to think like you, until a few serious health conditions came up with me (I'm battling one now in fact). And insurance has helped me out a ton. Had a $18,000 surgery, that I only had to pay 200 bucks for. Tons of office visits, that I've only had to pay 10 dollar co-pays for.

    I hope nothing happens to you, but I'd advise you to get some sort of minimal health coverage at the least.


    if that happened (knock on wood that it doesn't), I would file for emergency medi-cal and that would cover it.
    I really screwed that up. I really Schruted it.
  • Phantom Pain
    Phantom Pain Posts: 9,876
    cat72 wrote:
    I was taking zantac before it went otc. My pharmacist recomended that my doc write the script for the generic. If they write for the name brand the insurance company wont pay for it. By writing it for the generic the insurance pays. I was always taking the generic, but according to state law they have to fill generic unless the doc specifically states name brand only. Don't know if this will help you?

    This drug is new and there is no generic available yet

    The drug companies have gotten slick in that they put the med OTC rather then make say Zyrtec in generic

    They make a ton of money off of the OTC staying as their Brand
    My drinking team has a hockey problem

    The ONLY thing better than a glass of beer is tea with Miss McGill



    A protuberance of flesh above the waistband of a tight pair of trousers
  • Indian Summer
    Indian Summer Posts: 2,296
    _Crazy_Mary_ wrote:
    if that happened (knock on wood that it doesn't), I would file for emergency medi-cal and that would cover it.

    So our tax money should cover you because you're a cheapskate? No wonder our country is in such debt!
    "It's all happening"

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