The most you ever paid for a prescription

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Church Lady
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The most you ever paid for a prescription

Post by Church Lady » Tue Oct 30, 2018 8:48 pm

It's that time of year again -- open enrollment. I'm mulling my choices. One implication of the plan I choose is the amount of prescription drug coverage I get.

All plans offer the same prescription co-pays, formulary, and pharmacy. The only prescription coverage difference among the plans that I can see is the annual maximum the company will pay towards prescriptions.

Low deductible/high premium plan has NO ANNUAL MAXIMUM for prescription drug coverage.
Medium deductible/somewhat lower premium has a $2500 annual limit for prescription drug coverage.
HIgh deductible/lower premium has a $1000 annual limit for prescription drug coverage.

I'm on about five prescriptions, but even $1000 a year would handle my routine needs. HOWEVER, one of my relatives was handed an $800 prescription this afternoon. ... a single prescription! :shock: (to treat Shingles. Don't get Shingles!)

This has me wondering just how expensive prescriptions can get, and whether I should opt for $2500 or unlimited prescription coverage.

What is the highest you have paid for a prescription, be it short term or long term? Please don't give too many details about the medication if you want to keep your ailments confidential. Thanks!
He that loveth silver shall not be satisfied with silver; nor he that loveth abundance with increase: this is also vanity. Ecclesiastes 1:8

bob60014
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Re: The most you ever paid for a prescription

Post by bob60014 » Tue Oct 30, 2018 8:52 pm

$3.00

JustDumb
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Re: The most you ever paid for a prescription

Post by JustDumb » Tue Oct 30, 2018 8:55 pm

Church Lady wrote:
Tue Oct 30, 2018 8:48 pm
It's that time of year again -- open enrollment. I'm mulling my choices. One implication of the plan I choose is the amount of prescription drug coverage I get.

All plans offer the same prescription co-pays, formulary, and pharmacy. The only prescription coverage difference among the plans that I can see is the annual maximum the company will pay towards prescriptions.

Low deductible/high premium plan has NO ANNUAL MAXIMUM for prescription drug coverage.
Medium deductible/somewhat lower premium has a $2500 annual limit for prescription drug coverage.
HIgh deductible/lower premium has a $1000 annual limit for prescription drug coverage.

I'm on about five prescriptions, but even $1000 a year would handle my routine needs. HOWEVER, one of my relatives was handed an $800 prescription this afternoon. ... a single prescription! :shock: (to treat Shingles. Don't get Shingles!)

This has me wondering just how expensive prescriptions can get, and whether I should opt for $2500 or unlimited prescription coverage.

What is the highest you have paid for a prescription, be it short term or long term? Please don't give too many details about the medication if you want to keep your ailments confidential. Thanks!




$600 epipen

Dottie57
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Re: The most you ever paid for a prescription

Post by Dottie57 » Tue Oct 30, 2018 9:06 pm

$290 for a tray of restasis eye drops.

123
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Re: The most you ever paid for a prescription

Post by 123 » Tue Oct 30, 2018 9:07 pm

If you want to find the name of a high-priced prescription all you have to do is investigate the cost of any prescription drug that is advertised on those special drug commercials on TV. The ones I've looked up usually have a cost of $20 - $50 or more per DOSE. Often $thousand$ per month. Most of them say that side effects can include kidney or liver problems etc. Yes they want you talk to your doctor to get him to prescribe it for you. Either the insurance or you will pay for it. It costs a lot to advertise like that on TV, they wouldn't do it if it wasn't profitable.
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unclescrooge
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Re: The most you ever paid for a prescription

Post by unclescrooge » Tue Oct 30, 2018 9:09 pm

I just paid $345 for a month's supply of a non-life threatening drug.

Immediately ordered 3 months supply from Canada for $270.

treadingwater
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Re: The most you ever paid for a prescription

Post by treadingwater » Tue Oct 30, 2018 9:21 pm

Expensive prescriptions can sometimes be changed to therapeutic equivilents that are much less expensive. Always ask the pharmacist and or Dr if there are alternatives to costly meds. There are manufacturer coupons available on some brand name drugs that can be found at the manufacturers website. These can really help also. Goodrx is a website that may be used on cash pay rxs to reduce the cost. Check it before purchasing your rx to see if its cheaper there or on your insurance.

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TimeRunner
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Re: The most you ever paid for a prescription

Post by TimeRunner » Tue Oct 30, 2018 9:29 pm

JustDumb wrote:
Tue Oct 30, 2018 8:55 pm
$600 epipen
This.

But now that there's a generic, that's $20! :shock:
“Some depart to remain.”

sawhorse
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Re: The most you ever paid for a prescription

Post by sawhorse » Tue Oct 30, 2018 9:57 pm

$980 per week, but I don't take that medication because I can't afford it and insurance rejected it.

I take one that was $1200 a month out of pocket as insurance won't cover it. I now get it from Canada for $500.

In total my insurance company, even without paying 2 of my prescriptions, spends $1000-1500 a month on my prescriptions. My co-pays are about $300 a month. I get a statement of benefits showing how much they spent on drugs. At their highest, insurance was spending over $5000 every month on my covered drugs. The highest months were over $10k.

Prescription drug prices and inflation of such prices are out of control in this country. There are decades old generics that are tens of thousands of dollars every month.
Last edited by sawhorse on Tue Oct 30, 2018 10:11 pm, edited 1 time in total.

ResearchMed
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Re: The most you ever paid for a prescription

Post by ResearchMed » Tue Oct 30, 2018 10:03 pm

I've had several expensive meds over the years.

The most expensive that I can think of right now that either of us have now is billed to the insurance company at about $1,100 per month, year-round. It would be a $45 co-pay for me, except that I hit the out-of-pocket maximum approximately 1/2 to 2/3 of the year out, every year.

We've never added up what *all* of our meds would have cost per year, and all I can say, it would be a fairly staggering number.
Even a generic cholesterol med (and only a very low dose) is billed to insurer at $8xx (not $8.xx) each refill.
That's the *generic* version. :shock:
And yes, it made a dramatic difference, so I guess I'm on it long term...

I'm pretty sure that we've had an occasional antibiotic that was *very* expensive, but at least, those aren't maintenance meds.

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ClevrChico
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Re: The most you ever paid for a prescription

Post by ClevrChico » Tue Oct 30, 2018 10:10 pm

$200. Luckily we then found an online coupon to knock it down to around $20. Went to pharmacy and they reprocessed it as $20.

But if one uses Medicare/medicaid they cannot use the coupon, and it's processed as the full amount. :confused

runner3081
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Re: The most you ever paid for a prescription

Post by runner3081 » Tue Oct 30, 2018 10:17 pm

$57 for a 3-month supply.

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celia
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Re: The most you ever paid for a prescription

Post by celia » Tue Oct 30, 2018 10:18 pm

I know someone on lots of meds who picks them up quarterly (to avoid going in every week). Several of their meds are over $1,000 for 3 months but they only need to pay $300-$400 each when they are in the Medicare donut hole (and full price when the deductible has not yet been yet). They often leave with $1,000 charged to their credit card.

I assume you are talking about an employer insurance plan, however, where the costs are level all year long.

carolinaman
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Re: The most you ever paid for a prescription

Post by carolinaman » Wed Oct 31, 2018 8:51 am

$300 for 90 day supply of a premium drug I take. It was not covered from my prescription plan

SimonJester
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Re: The most you ever paid for a prescription

Post by SimonJester » Wed Oct 31, 2018 9:13 am

Around $350 - $400 for one DS monthly prescriptions, and it does suck being on a HDHP. My father was on a prescription that ran $10K per month with a 3K hospital charge to inject it! :shock: :shock: :shock: He was thankful it was covered medicare / medicaid...
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Re: The most you ever paid for a prescription

Post by Jack FFR1846 » Wed Oct 31, 2018 9:14 am

$900 for 90 days of sites for an insulin pump. We have no prescription max but have deductibles and copays. Fortunately, we have an annual out of pocket max. We typically hit that in the beginning of July
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Rupert
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Re: The most you ever paid for a prescription

Post by Rupert » Wed Oct 31, 2018 9:19 am

My arthritis drug costs over $5000/month. There is no generic, and there are no comparable alternative drugs that are cheaper. Choosing not to take it is also not an option as I would become disabled rather quickly.

Edited to note: This is not what I pay. This is the price negotiated by the insurance company with the pharmacy and mostly paid by the insurance company. An insurance plan with a $2500 cap on prescription drugs would obviously be a non-starter for me and many others. Note that the drug I take is one of the world's top-selling medications, so it is not at all unusual.
Last edited by Rupert on Wed Oct 31, 2018 1:22 pm, edited 1 time in total.

gailcox
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Re: The most you ever paid for a prescription

Post by gailcox » Wed Oct 31, 2018 9:58 am

$387 per month for Voriconazole for my dog!! Yes, my dog! I carried this on for a few months until I realized Costco could be cheaper and it was. It varied from $60-$120 a month from Costco.

Bir48die
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Re: The most you ever paid for a prescription

Post by Bir48die » Wed Oct 31, 2018 10:22 am

$30/mth for Viagra :)

Now I just go to Mexico and re-stock

Broken Man 1999
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Re: The most you ever paid for a prescription

Post by Broken Man 1999 » Wed Oct 31, 2018 10:28 am

The co-pay for two of my prescriptions amounts to $40 each for 90 day supplies. All other prescriptions are $0 for 90 day supplies. DW and I have very good retiree insurance from MegaCorp. I just hope it continues. Haven't received the 2019 costs, keeping my fingers crossed......

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nisiprius
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Re: The most you ever paid for a prescription

Post by nisiprius » Wed Oct 31, 2018 10:33 am

My parents paid $75 in 1951 for a tiny bottle of aureomycin. I don't know how big it was, quite possibly 1 dram. That's the equivalent of $750 today.

It didn't work, because it was either a virus infection or possibly coccidioidomycosis.

I do not think a $2,500 annual limit is safe. I wouldn't risk it. If the "unlimited" costs significantly more than the $2,500 limit, you have to ask "why?" Probably because they really do need to pay big claims.

Insurance is insurance. You don't buy it to cover the average costs, you buy it to take care of the tail risk.
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ladycat
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Re: The most you ever paid for a prescription

Post by ladycat » Wed Oct 31, 2018 10:44 am

Several years ago my Mother paid $800 for Noxafil to treat pneumonia. Multiple refils needed. But she said it tasted great!

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Jimbo9911
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Re: The most you ever paid for a prescription

Post by Jimbo9911 » Wed Oct 31, 2018 11:12 am

$326 for 30 day supply of Budesonide.
That is my co-pay. The cash price is over $1400.00.
We have Silver Scripts prescription insurance.

Jim

jacksonm
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Re: The most you ever paid for a prescription

Post by jacksonm » Wed Oct 31, 2018 11:26 am

I didn't pay it but when I tried to pick up a blood pressure medicine for my wife earlier this year the price was over $20k (forget the exact amount).

I have no idea what they did behind the scenes with the doctor and insurance company but eventually I returned for another medicine and the price was $0.

Texanbybirth
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Re: The most you ever paid for a prescription

Post by Texanbybirth » Wed Oct 31, 2018 11:29 am

A prescription I take daily costs us $1100/month. (Thankfully we meet our deductible in Feb/Mar (depending on much is leftover at year end), and it's $35/mo from there on out. :D )

mouses
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Re: The most you ever paid for a prescription

Post by mouses » Wed Oct 31, 2018 11:38 am

gailcox wrote:
Wed Oct 31, 2018 9:58 am
$387 per month for Voriconazole for my dog!! Yes, my dog! I carried this on for a few months until I realized Costco could be cheaper and it was. It varied from $60-$120 a month from Costco.
My cat is on an asthma med that costs $400 in the US and $100 from Canada, for two months.

I have two meds myself that run in Plan D initial coverage approx $500 me, $700 the plan and $1000 me and $1300 the plan. That's for three months.

Last year my out of pocket med costs were about $4200, since I fall into catastrophic coverage pretty quickly.

Awhile back I needed a couple of weeks of a specialized antibiotic, I think that was over $1000.

mouses
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Re: The most you ever paid for a prescription

Post by mouses » Wed Oct 31, 2018 11:48 am

Keep in mind almost all of these prices are big ripoffs. I used to believe the stuff about BigPharma needing these prices to cover research, then I saw the prices of old meds go through the stratosphere when people like PharmaBro bought the rights to them, and the nytimes ran an article on med prices and quoted some BigPharma employees laughing about how they had jacked up the prices of end of life cancer meds to like $100,000 a month.

So don't deduce from this thread that good medical care is unaffordable. It would be plenty affordable if the crooks were gotten out of the business.

juana
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Re: The most you ever paid for a prescription

Post by juana » Wed Oct 31, 2018 12:48 pm

Right now, $10,500.00 per month...medicare pays around 7 to 8 thousand...I pay out of pocket...From $3000.00 to $600.00 per month.

before medicare I paid $3999.00 per month out of pocket for Gleevec...and $3 to $4 thousand out of pocket for Tasigna, have done this for the past eight years. Tasigna price is $12000.00 per 28 days worth, but I only paid $2 to$ 3 thousand per 28 days worth, because insurance and medicare paid part.

magicbunny
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Re: The most you ever paid for a prescription

Post by magicbunny » Wed Oct 31, 2018 12:51 pm

nisiprius wrote:
Wed Oct 31, 2018 10:33 am
...
I do not think a $2,500 annual limit is safe. I wouldn't risk it. If the "unlimited" costs significantly more than the $2,500 limit, you have to ask "why?" Probably because they really do need to pay big claims.

Insurance is insurance. You don't buy it to cover the average costs, you buy it to take care of the tail risk.
+1 You want to insure against tail risks!

Best if prescriptions are covered 100% after some limit... maybe check what is covered after your annual out of pocket limit is reached?

Xeloda and other anticancer drugs are like $900 +

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jfn111
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Re: The most you ever paid for a prescription

Post by jfn111 » Wed Oct 31, 2018 1:12 pm

Wow, looking at what some people have to pay I'll quit bitching about the $58 dollars I pay every 3 months for Pantoprazole.

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dm200
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Re: The most you ever paid for a prescription

Post by dm200 » Wed Oct 31, 2018 1:19 pm

Can you, without restriction, switch next year to a plan with higher payments for prescriptions? That would be a factor, for me, in assessing the financial risk of going with a lower premium plan.

You question, though, is not the most folks paid, but the most charged/assessed - whether to you or to the insurance company.

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serbeer
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Re: The most you ever paid for a prescription

Post by serbeer » Wed Oct 31, 2018 1:21 pm

$50 -- the highest copay of my HMO, applied to brand-name and specialty-pharmacy drugs. Usually it is $15 regular copay.

How high can it go if not covered? Hepatatis C treatment recently made news with $100K price tag

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dm200
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Re: The most you ever paid for a prescription

Post by dm200 » Wed Oct 31, 2018 1:24 pm

HOWEVER, one of my relatives was handed an $800 prescription this afternoon. ... a single prescription! :shock: (to treat Shingles. Don't get Shingles!)
Right - there is a supply problem with the new (and more effective) Shingles vaccine. I was able to get the two shots -- but my wife is waiting to get further up the priority list.

Everyone I know who has gotten Shingles says how awful it is.

If you are over 50 - I would ask about the new vaccine - and do what you can to get it.
Last edited by dm200 on Wed Oct 31, 2018 1:25 pm, edited 1 time in total.

Rupert
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Re: The most you ever paid for a prescription

Post by Rupert » Wed Oct 31, 2018 1:25 pm

Isn't OP asking whether he/she should sign up for an insurance plan with a $2500 or $1000 cap on prescription coverage? So wouldn't the cost of your Rx, as opposed to what you pay out of pocket, be more relevant to him/her? Just wondering why people keep reporting only their co-pays.

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dm200
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Re: The most you ever paid for a prescription

Post by dm200 » Wed Oct 31, 2018 1:26 pm

Rupert wrote:
Wed Oct 31, 2018 1:25 pm
Isn't OP asking whether he/she should sign up for an insurance plan with a $2500 or $1000 cap on prescription coverage? So wouldn't the cost of your Rx, as opposed to what you pay out of pocket, be more relevant to him/her? Just wondering why people keep reporting only their co-pays.
Yes - I believe this is the relevant amount.

Retired2013
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Re: The most you ever paid for a prescription

Post by Retired2013 » Wed Oct 31, 2018 1:40 pm

I saw a specialist some years ago. The doctor looked at me and said " I THINK you have" xxx. Do you have drug coverage?

Yes.

He sends an electronic script to my pharmacy.

When I get home, the pharmacy calls me. They just wanted to notify me that they need to order the drug, but before they do that, they also wanted to let me know that it was going to be $750 for a one month supply.

I told the doctor that I had drug coverage but I didn't tell him it was a HDHP. I remember the doctor saying "I THINK I know what you have" so I rejected the drug. The the pharmacy called the doctor and had a new script sent with a cost of $45.


Another time my wife saw a PA at a specialist office. The PA writes a 90 day script to the mail pharmacy. She was told to come back next week.

Next week comes around. We go back to see the doctor, not the PA. The doctor said he was going to write an electronic script for drug "b". When we asked what about the drug "a" that the PA ordered, his response was, that drug "a" isn't going to help!

When we got home, the drug "a" the PA ordered was in the mail box. Cost, $1,800. Copay $80. After many phone calls, the mail order pharmacy let us return drug "a" and credited us back our $80. Don't know if the insurance was credited back any money.

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TomatoTomahto
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Re: The most you ever paid for a prescription

Post by TomatoTomahto » Wed Oct 31, 2018 1:44 pm

The retail price for 1500mg of metformin extended release generic (not in the insurance company’s formulary) was $1900 per month, so I chose not to fill the prescription. The price for 2x750mg extended release generic, in the formulary, was $0. 750+750=1500!!!! Doctor was happy to change the prescription. Winner!
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Small Law Survivor
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Re: The most you ever paid for a prescription

Post by Small Law Survivor » Wed Oct 31, 2018 2:04 pm

My wife's ophthalmologist has told her she must take Durezol. (difluprednate) indefinitely. These drops cost $250/month, and we have been told by BC/BS that they will not cover it.

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dm200
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Re: The most you ever paid for a prescription

Post by dm200 » Wed Oct 31, 2018 2:06 pm

Small Law Survivor wrote:
Wed Oct 31, 2018 2:04 pm
My wife's ophthalmologist has told her she must take Durezol. (difluprednate) indefinitely. These drops cost $250/month, and we have been told by BC/BS that they will not cover it.
Can a substitute be found for the condition?

ResearchMed
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Re: The most you ever paid for a prescription

Post by ResearchMed » Wed Oct 31, 2018 2:10 pm

Small Law Survivor wrote:
Wed Oct 31, 2018 2:04 pm
My wife's ophthalmologist has told her she must take Durezol. (difluprednate) indefinitely. These drops cost $250/month, and we have been told by BC/BS that they will not cover it.
For you (and others where insurance has declined to cover a particular Rx), have you appealed the decision?
Sometimes all it takes isn't even any formal appeal, but a call from the physician explaining why this is necessary, e.g., a commonly used lower-cost alternative med was tried but didn't work (or there were side effects), etc.
It can also help if physician is able to state (or even document from a previous experience) that IF this med isn't taken, then there is likely to be a much higher cost from something like inpatient hospital care, etc.

We've never needed to do any sort of "formal appeal", as the the above efforts have worked, although with a bit of aggravation sometimes.

It's worth a try, especially if it is likely to be a long-term Rx.

RM
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ResearchMed
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Re: The most you ever paid for a prescription

Post by ResearchMed » Wed Oct 31, 2018 2:11 pm

dm200 wrote:
Wed Oct 31, 2018 2:06 pm
Small Law Survivor wrote:
Wed Oct 31, 2018 2:04 pm
My wife's ophthalmologist has told her she must take Durezol. (difluprednate) indefinitely. These drops cost $250/month, and we have been told by BC/BS that they will not cover it.
Can a substitute be found for the condition?
You want to find a different condition?

:D :wink:

RM
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dm200
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Re: The most you ever paid for a prescription

Post by dm200 » Wed Oct 31, 2018 2:14 pm

ResearchMed wrote:
Wed Oct 31, 2018 2:11 pm
dm200 wrote:
Wed Oct 31, 2018 2:06 pm
Small Law Survivor wrote:
Wed Oct 31, 2018 2:04 pm
My wife's ophthalmologist has told her she must take Durezol. (difluprednate) indefinitely. These drops cost $250/month, and we have been told by BC/BS that they will not cover it.
Can a substitute be found for the condition?
You want to find a different condition?
:D :wink:
RM
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Small Law Survivor
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Re: The most you ever paid for a prescription

Post by Small Law Survivor » Wed Oct 31, 2018 2:16 pm

ResearchMed wrote:
Wed Oct 31, 2018 2:10 pm
Small Law Survivor wrote:
Wed Oct 31, 2018 2:04 pm
My wife's ophthalmologist has told her she must take Durezol. (difluprednate) indefinitely. These drops cost $250/month, and we have been told by BC/BS that they will not cover it.
For you (and others where insurance has declined to cover a particular Rx), have you appealed the decision?
Sometimes all it takes isn't even any formal appeal, but a call from the physician explaining why this is necessary, e.g., a commonly used lower-cost alternative med was tried but didn't work (or there were side effects), etc.
It can also help if physician is able to state (or even document from a previous experience) that IF this med isn't taken, then there is likely to be a much higher cost from something like inpatient hospital care, etc.

We've never needed to do any sort of "formal appeal", as the the above efforts have worked, although with a bit of aggravation sometimes.

It's worth a try, especially if it is likely to be a long-term Rx.

RM
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simplesimon
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Re: The most you ever paid for a prescription

Post by simplesimon » Wed Oct 31, 2018 2:17 pm

I have seen a bill for Remicade that was something like $18k, infused once every eight weeks.

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Sheepdog
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Re: The most you ever paid for a prescription

Post by Sheepdog » Wed Oct 31, 2018 2:31 pm

My wife has these high price monthly prescription:

Tradjenta $1145.49 (her out of pocket for that is $226. The insurance company covers the rest. However after the doughnut hole, that is now and until the end of the year costs her now only $20.02 out of pocket until Jan 1 when it will go back up.)

Trulicity $876 (her out of pocket is $249.44) However after the doughnut hole, that is now and until the end of the year changed to $35.52 out of pocket when it will go back up.)

I don't have any high priced drugs
It's not what you gather, but what you scatter which tells what kind of life you have lived---Helen Walton

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dm200
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Re: The most you ever paid for a prescription

Post by dm200 » Wed Oct 31, 2018 2:54 pm

Many Physicians rely on drug company reps for "education" on what prescription drugs to prescribe. Of course, these reps will push the more expansive and profitable (to the drug company) choices.

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queso
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Re: The most you ever paid for a prescription

Post by queso » Wed Oct 31, 2018 2:57 pm

Went to pick up heartburn/ulcer medication the other day and they wanted something like $510 for it (out of pocket). Darn this HDHP.. Left without the meds, but hit my out of pocket max when I had an endoscopy so had them call back in the script and now it is $50. Guess I'll go get it tonight. :happy

My antihistamine nasal spray (azelastine) is around $100 a month out of pocket as well. Most of this stuff was $10-$20 before I went to HDHP/HSA. I need to find some generic options..

ResearchMed
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Re: The most you ever paid for a prescription

Post by ResearchMed » Wed Oct 31, 2018 3:03 pm

queso wrote:
Wed Oct 31, 2018 2:57 pm
Went to pick up heartburn/ulcer medication the other day and they wanted something like $510 for it (out of pocket). Darn this HDHP.. Left without the meds, but hit my out of pocket max when I had an endoscopy so had them call back in the script and now it is $50. Guess I'll go get it tonight. :happy

My antihistamine nasal spray (azelastine) is around $100 a month out of pocket as well. Most of this stuff was $10-$20 before I went to HDHP/HSA. I need to find some generic options..
Was the $100 before you hit your OOP max?

If you are likely to hit the OOP max during any year, you might as well not hold back on things like the heartburn/ulcer meds, as you'll spend the same during the year anyway. It would only be that you'd hit it/pay the OOP max sooner in the year.

Or, if you don't usually hit the OOP max, then this year, try to get extra supplies of long-term meds, perhaps using 90-day supply in December, now that you've already hit the OOP max.
Then you'd have less to pay for next year.

RM
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AtlasShrugged?
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Re: The most you ever paid for a prescription

Post by AtlasShrugged? » Wed Oct 31, 2018 3:06 pm

I had to laugh....For Humira, the 'off the shelf' price is $1,250 per injection, with two monthly injections needed. If we are talking Remicade, we are talking infusion, and 8,000 to 10,000 every six to eight weeks is not unusual.

Here is the 'laugh' part. Thanks to Abb Vie (really, they are an awesome company who really does look out for patient interests), I pay exactly $5 for two shots of Humira.
“If you don't know, the thing to do is not to get scared, but to learn.”

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queso
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Re: The most you ever paid for a prescription

Post by queso » Wed Oct 31, 2018 3:09 pm

ResearchMed wrote:
Wed Oct 31, 2018 3:03 pm
queso wrote:
Wed Oct 31, 2018 2:57 pm
Went to pick up heartburn/ulcer medication the other day and they wanted something like $510 for it (out of pocket). Darn this HDHP.. Left without the meds, but hit my out of pocket max when I had an endoscopy so had them call back in the script and now it is $50. Guess I'll go get it tonight. :happy

My antihistamine nasal spray (azelastine) is around $100 a month out of pocket as well. Most of this stuff was $10-$20 before I went to HDHP/HSA. I need to find some generic options..
Was the $100 before you hit your OOP max?

If you are likely to hit the OOP max during any year, you might as well not hold back on things like the heartburn/ulcer meds, as you'll spend the same during the year anyway. It would only be that you'd hit it/pay the OOP max sooner in the year.

Or, if you don't usually hit the OOP max, then this year, try to get extra supplies of long-term meds, perhaps using 90-day supply in December, now that you've already hit the OOP max.
Then you'd have less to pay for next year.

RM
Yep, the $100 is a monthly prescription, but I normally never hit the OOP max. This was a weird year with a couple of issues that pushed me to the max so now I am scheduling as much stuff as I can over the next couple of months. I think the $500 was a completely visceral reaction that caught me by surprise when she rung me up so I didn't think through it. CVS brand Tums were like buy one get one free so I couldn't get my head around $500 heartburn medicine. I also wasn't sure the endo would put me up and over, but once I paid the bill and realized I hit it now the fancy meds seem like a no brainer. :happy

Good idea on the 90 day supply..

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