Drug costs

[Colt]

Now that I have medical care I've optimistically started running around looking at all my medication options but it's really breaking my heart because all I can find that I could ever afford is prednisone. Even with my new job at a hospital which earns me half priced medications.


According to RXPrice Guide (http://www.regencerx.com)
Prednisone: $5
Entocort: $406
Asacol: $277
Pentasa: $298
Humira: $1,627

My measly budget for my entire medical care is $100 per month. That's supposed to eventually build up to get me a colonoscopy too.

 

[ladyB]

What about moving to a job that has better coverage?
My hubby works the night shift so we can have decent health coverage(there are other reasons why he works too...lol) he insurance is what makes him stay tho.

 

[mommy1st]

Can you qualify for any kind of medical assistance? Do you have medical coverage for your baby?

 

[jed]

jeeez, you guys gotta move to aus, almost free here.

plus i know someone in customs, i can have your mother in law banned from entering the country

 

[ladyB]

jeeez, you guys gotta move to aus, almost free here.

plus i know someone in customs, i can have your mother in law banned from entering the country

:ylol2:

 

[Colt]

Wow jed, thanks. I don't think I could afford the move though. Immigration isn't as easy as you would think.

I just scoured the medical plan for my new job. The insurance is really good. Well, good for american insurance. Basically, I think I might be able to get away with some additional treatment. I'd only have to pay 20% of my medication costs. It's $100 a month though. I could also see a GP for $10 per visit and a GI for $20.

So..

Prednisone: $7
Entocort: $81
Asacol: $55
Pentasa: $60
Humira: $325

But... remember I've budgeted $100 for medical expenses and $100 only gets me the coverage and none of the copays.

1 GP and 2 GI visits: $50
Colonoscopy: $250 (lab/test deductible with no copay, woot!)
Colonoscopy Prep: $14 (It's a guess based on the $7 or 20% whichever is greater)
Sed Rate and CBC: $0 (Lab/test deductible with no copay, woot!)

So before I even get started on medication I've spent $314 over my budget. Medication will all be over-budget as well.

But.. with my pay raise I'll be making $257 more per month. It would be kind of sad to see almost every penny of that go to something like Remicade which would be $250 per month with 8 weeks between transfusions. There is an out-of-pocket limit of $2,250 per year so I guess it would really work out to be $187.50 per month on average. Still.. this all ends up being a crap load of money no matter what. Thousands of dollars that could have been spent on things to improve my family's quality of life. Plus, don't forget that all my Dr. visits and the $250 per year for my tests. I could end up with medical care, but less money to bring home than before I got the job.

Also, don't mistake this for typical American insurance. Remember I work for a hospital and all of this requires that I use nothing but the services of this hospital and the clinics it owns.

 

[kromom1]

Yeah, Colt. I was going to say the same thing Mike just told you. It's a great program. I have gotten my Humira free for 4 or 5 months now! Good luck to you and congratulations on the new job.

Lisa

 

[Colt]

There's no way on earth I could put down $1,000 on anything.

 

[My Butt Hurts]

Dude - move to Aus and have your mother-in-law BANNED?!?!?
SO worth it! If I were you I might even move to hell if she didn't come too.

Did your work hours change with your new job? Is it daytime? Did you start yet? Could this help your relationship??
Congrats on teh new job.

 

[Colt]

My hours are 5AM-3:30AM 4 days a week. That's pretty good. Instead of getting up at 9PM an hour after my wife goes to bed I'll be getting up at 3:30AM, 2 hours before she gets up. Bed time should be around the same time as her.

During training (a month, maybe a month and a half) I'll be working 8AM-5:30PM.

I have orientation for the hospital on Oct. 6 when I'll get signed up for my snazzy new insurance (those suckers will regret forgetting a pre-existing conditions clause after I'm done with them). I start training in the clinic on Oct. 7. So, if you're in the area come by and let me stab you.

 

[kromom1]

There's no way on earth I could put down $1,000 on anything.

No, you probably wouldn't have to pay anything for the humira for the first 6 months on this plan. With your insurance, it looks like you would be expected to pay $325 a month, but the assistance plan will pay that for you (they pay up to $1000 a month of what you would have to pay through your insurance plan for the first month, then up to $325 a month of what you would have to pay through your insurance plan for months 2-6, then up to $325 a month of what you would have to pay through your insurance for the next 6 months after you pay a $50 copay). So months 7-12 would probably cost you $50 a month. They told me it may start over then in the second year, but that wasn't definite yet. I hope I explained that all clearly. :yrolleyes: :confused2:

Lisa

 

[Colt]

I went to the clinic and as I thought they couldn't do anything more than my own doctor could do so all it did was cost me $30. The nurse practitioner was really gung-ho though and was going to send me home with a perscription for asacol. I mentioned pentasa and she didn't know anything about it but she was sure I did so okay.

Anyway, I put it off until I could get an appointment with a GI because there are monitoring and diagnostic concerns and such. They sent off a referral for me effective after my insurance is going to kick in. I confirmed with my employer that the insurance does indeed include pre-existing conditions so I'm set.

There was one thing that clinic could do for me that my normal doctor couldn't though and that was they have an employee who does nothing but work to get people free prescriptions. They said they should be able to get the pentasa for me completely free. That would be awesome. Just doing something like you guys were saying with paying my 20% for me would be wonderful.

Gung-ho NPC set me home with 60 darvocet too. That means I should be able to use it more frequently and not have to wait until I'm doubled over.

I think I'll keep my GP for now since he's paid up until the end of the year and this clinic is costing me $30 per visit. He's a bit better informed too. I have an appointment with him on monday to work out what to do in the interim.

 

[kromom1]

Sounds like things are starting to look up for you, Colt! Can't beat free meds! Hang in there!

Lisa

 

[teeny5]

Here is what I paid for my meds and their regular price:

Prilosec 20 mg. $10.00 (reg. $40.18) for 30 pills
Entocort 3 mg. $60.00 (reg. $842.47) for 56 pills
Sulfazine (Azulfidine) 500 mg. $30.00 (reg. $52.38) for 100 pills
Asacol 400 mg. $90.00 (reg. $789.48) for 100 pills
Mesalamine (Rowasa) 4 gm. $10.00 (reg. $231.93) for 28
Golytly (Colonoscopy prep) $10.00 (reg. $16.30)

Crazy how much some of these drugs cost. Does anyone know can you write off your medical expenses on your taxes? I have been keeping all my receipts just in case.

 

[Colt]

Yes you can but you'll need to itemize your deductions which can be a pain and isn't usually profitable unless you have a LOT of deductions such as being self-employed.

 

[teeny5]

We already do some itemizing since my husband is in construction and buys his own tools and such. I will take the receipts with me...our tax guy will figure out what is best...Thanks!

 

[My Butt Hurts]

Sounds good Colt!
You're posts haven't sounded this "up" in, well, ever.
Heck - you even used a smiley face!
Better hours - maybe a bit less stress - real doctor appointments - feel better!

 

[Colt]

Yeah, I have been feeling more hopeful than normal. I'm surprised everyone's been so tolerant. Being back to my pre-prednisone flaring state is starting to frustrate me though. Friday I got so frustrated with the excruciating pain of stirring the wok (It's humiliating that such a task would ever be near impossible) that I had a hissy fit and kicked a pillow across the room though. My mood's been kind of up and down on the whim of rapidly changing circumstances as of late.

That, and I'm starting to seem like a real loser in the child care department again which is really frustrating me because I have to worry about the 'do more' stuff. Objectively I know the 'do more' stuff is exaggerated and I'm not really doing bad but considering the pressure and the unrealistic standards I'm being held to it nothing seems like it's enough to me, and especially to them.