So angry at medicare and insuance

Discussion in 'Fibromyalgia Main Forum' started by rosemarie, Mar 4, 2012.

  1. rosemarie

    rosemarie Member

    Last month I got my soma filled at it;s new tier a tier 3, I was surprised when it cost me just $ 17.24, so when I went to fill it this month I was shocked when the cashier told me that it was $35.00 for the soma, I had them call the insurance who said that medicare makes up the prices I did over hear the tech that called ask "Sop does this mean you can raise the price when ever you please?" by the look on her face I think she didn't like the answer she got.

    She told me to call them and when I did I was t old that aa teir 3 is $44.00 and unless it costs more than that they don't pay any copay for it. She had no clue as to why teh cost was so high this month and basicly I got told that medicare decides what drugs cost. I asked about the soma because it is a grandfather drug, Meaning it is older than 30 yrs old. I have taken it when I was younger in my teens. It means nothing.

    I guess that I am at the mercy of medicare and my insurance for the cost of my meds. It did seems strange to me that none of the other meds went up higher. Just the soma, I don't understand why this med?

    Still irratated but trying to deal with it, I can't change the price no matter who controls it so I may as wel budget for a higher price and learn to live with it. But it still upsets me as I have to pay for my own scripts and I don't get a big alotment from SSDI. That is what I get for not working full time and staying home to be a mommy. I would not change the staying home to be the mommy I Loved it alot. I wish I had been paid better when I did work full and part time. But again I can't change that so why worry about it now.
    Thanks for letting me vent
    SO I am just screwed , for all I Know next month it will cost me $44.00 or higher, if I am lucky it will go lower again. The price at the pharmacy stayed the same price for both months , so I Know that the pharmacy didn't raise it's price.
  2. mbofov

    mbofov Active Member

    I don't blame you for being frustrated. Although I don't think Medicare sets the tiers - I think the various insurance companies decide what tier each drug goes into (they are all different) and how much you pay for each tier etc.

    I'm in southern California and have AAA (Auto Club), and just by being a member I get a discount on prescription drugs - I do better using my AAA discount than the Medicare prescription drug plan I have, which has never paid a penny. I don't take many meds, and they don't cost that much, but I do find that AAA helps me more.

    Also, some pharmacies have their own type of prescription drug plan. You might want to check around and see what the various pharmacies offer.

    I keep my Medicare prescription drug plan on the chance that someday I may need a really pricey med, but so far it hasn't happened (knock on wood!)

  3. lea

    lea Member

    Walgreens discount card. They have a discount card that costs around $20 and gives fairly good discounts.
    Check them out, especially if you've AARP.

    actually you can go to their site to get prices without actually having their card.
    good luck

    Ann[This Message was Edited on 03/05/2012]
  4. JLH

    JLH New Member

    Could the price difference for your Soma be that someone at the pharmacy filled the cheaper one with a generic Soma, and then the next time it was filled with the name brand Soma, resulting in a higher price??????

    I am on a really new drug that would cost me over $900/month had I have to pay for it out of my pocket. Luckily, with my insurance, I pay only $45/month. I feel very blessed to have it covered by my insurance at all. Regardless of cost, I need to have it because it is a life-saving drug. It is a tier 3, or whatever the highest tier is, and it is not on my insurance's formulary, so I have to pay $45 instead of the normal $30/month.

    Unfortunately, I take 29 prescriptions a month and have to budget for all of them, too.

    But, I still feel blessed to have insurance. Rather than use the Medicare drug insurance, I use the drug insurance from my employer (I'm retired) because it is much better--you can't use both. With having to take as many meds as I do, I would certainly be up the creek without a paddle if I had to pay full price for all of them!!!

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