Prescriptions and denials thereof....

[Knight]

The State of N.J. uses OptumRX for our retiree Health Benefits Program. The most expensive medications, including Eliquis, cost me $28 for 90 day supplies. All of my glaucoma eye drops are $28. About half my prescriptions are $5 and under and half cost $28. It's astonishing to look at the claim forms and see how much those medications would cost without insurance. For Eliquis, it shows that my plan paid $718 this year (I had the prescription filled once this year).

Re the OP: My glaucoma specialist sent two different RXs for preservative free lubricating drops to two different pharmacies because she said insurance companies don't usually pay for them. One pharmacy was Blink Rx and they sent the Miebo drops free of charge. I'm sure if I reordered they wouldn't be free, but I won't because they make my vision blurry. I declined accepting the other RX when the pharmacy called.

I forgot the name of the pharmacy and drops but they were $195 with a special first time price of $59 for a month's supply.
I can't see paying $59 for a month of a lubricant drop then possibly $195 to refill. The doctor gave me a bottle of Ivizia, which I like so far, but I also found that Systane has preservative free drops, so I ordered that from Amazon. Two bottles for $19. I have used the original Systane Ultra for years and really liked it.

Good to know. If it OK with you I'm going copy the 1st paragraph to send to the agent that deals with my plan

 

[OneEyedDiva]

Good to know. If it OK with you I'm going copy the 1st paragraph to send to the agent that deals with my plan

I don't mind Knight. I'm wondering, though, if the difference in pricing is because my coverage is by a state agency's group plan.

 

[dobielvr]

my spouse is on ELIQUIS. He applied for a program thru drug company and gets it for $15 a month. someone in doctors' offices had him sign up as he would have had some outrageous co-pay.
I do not get why places do not have real prices for all instead of cost depends on what hoops you jump thru or if someone shows you the process.

My brother takes that drug and I think he said he pays $500 a month...and he has insurance. I'm going to tell him about contacting the company, but I'm not sure if he'd qualify. Thx for the info.

 

[dobielvr]

Friends are saying crushcost discounts are better than GoodRx.

Doesn't cost anything to check it out and compare.

Going to check that out...thx.

 

[Knight]

I don't mind Knight. I'm wondering, though, if the difference in pricing is because my coverage is by a state agency's group plan.

That might make a difference. Now that you said you don't mind I'll email the agent that set up our plan to see what he thinks.

 

[OneEyedDiva]

My brother takes that drug and I think he said he pays $500 a month...and he has insurance. I'm going to tell him about contacting the company, but I'm not sure if he'd qualify. Thx for the info.

That's outrageous Dobielvr!! I hope your brother can find a much better price using one of the suggested options.

That might make a difference. Now that you said you don't mind I'll email the agent that set up our plan to see what he thinks.

Please let me know what he says. I'm curious now.

 

[dobielvr]

That's outrageous Dobielvr!! I hope your brother can find a much better price using one of the suggested options.

I will be seeing him this wknd, so I'll speak to him then.

My sister runs up against the same thing with her heart meds. I've been able to steer her towards GoodRX and take advantage of their pricing, plus CVS always comes through with some coupons they have online.