When I called the insurance company I was transferred a couple of times, until I ended up with the prescription drug plan. It hadn't occurred to me that this drug may not be covered. I kept thinking that it was part of my medical insurance, like the doctors and the hospital. But its not. It's a prescription, just like any other drug your doctor might want you to take. My plan had a copay of $0-$25-$50, depending on the drug. The best part was that I could have little or no copay. The worst was that it might not be covered at all. That's why the per authorization. If the drug was going to be covered it would cost the insurance company a lot of money.
When I finally talked to someone, they told me that the authorization was done approved yet and we should call back the next day. They continued that anytime a drug is over $1000 it needs a pre authorized, and that this drug was approximately $11,000.
That price was for a one month supply. Actually the plan was to take two capsules a day for seven day, wait a week, and then repeat. So in a month Marie would be taking a total of 28 capsules per month.
If you do the math, 28 capsules, per month, at $11,000 calculates to $392 for each capsule. Marie needed to do this for three months before the medicals could tell if it was working.
WOW.. You have to be rich to be sick....... It's not bad enough you have so much surgeries, stress, pressure, problems, sickness, side affects, complications, etc. from all the health issues.....but then you have to be put through hell with the insurance companies. It's just awful. George - you are a special man.
ReplyDelete~Michelle