Prescription Drug Costs

I don’t know if my story applies to many others, but here goes. My husband received a kidney transplant in October 2009. Since that time, he’s been on three different daily doses of anti-rejection drugs. Fortunately, our employer-provided health insurance has covered them and his other medications with very reasonable copays. The highest has been $15 for a month’s supply. Imagine my surprise when last week I was notified by our pharmacy that the copay for one was now $100 for a month’s supply. It’s very shocking when you are on a fixed retirement income and so many other costs are rising. I called our prescription drug provider and was told that as per the agreement, if a month’s supply was under $1000 the copay was $15 maximum but if it exceeds $1000, then the copay becomes $100. His myfortic acid had gone from $967 to $1027, a $50 increase. So, now our copay increased from $15 to $100, an $85 increase. Insane, I told the insurance customer service person. She reminded me of all the years it had only been $15 and said I could be grateful for that.

I called the pharmacy and was told they could try to submit it to Medicare Part B if they had a prescription from his nephrologist listing his diagnosis. So, I called the doctor and requested they send the pharmacy an updated prescription. Imagine my delight and surprise when I got notified by the pharmacy that his prescription was ready to pick up and the copay was ZERO! I’m happy but wondering why this wasn’t done way back when he first started this medication. Oh well, as least it’s covered now and I hope and pray Republicans don’t find a way to cut Medicare in the future as those cuts hurt people in ways the lawmakers can’t even imagine. If any of this resonates with you, please pass it on or comment. Thank you.