I am pretty savy when it comes to finding coupons, rebates etc. I save so much money at the grocery store with my digital coupons they have to have the manager do an override usually. We all know that prescription pricing is literally the wild west and I have yet to have anyone explain the pricing of drugs, or those handy dandy patent rules or how patient assis / savings cards from manufacturer programs work. I have been down the prior auth road many times and most of the time it works out. I am relentless and have even made appts with my husband's HR and taken up their lack of coverage directly with them.
Today's insurance issue: I need this- ahem- 'ring' for inside me to help with menopause symptoms. It was sent to my local pharm. Its a 90 day thing- in on day 1 out on day 90. First I was told that if I want a 90 day supply I have to use mail order (its one ring not 90 pills!). Then the dr sent it to my rx company. I called them and after being on hold and disconnected for over an hour I was told that in fact they didnt cover it at all. So I googled and found out the company has a rx savings rebate. I could pay as low as 25$ per ring. I called my local pharmacy back and they said that the card is only good for people with insurance that DOES cover it but that has a high copay. Well if my insurance doesnt cover it why cant I get help with programs like these? I thought the manufacturers sort of had a fund for stuff like this, and the promotional value of more people using it- I thought would be a company incentive. One ring is between 500-690 according to goodrx. My highest copay is 40$ so I could really use the help. And if you have medicare or medicaid and need help? Forget it with the manufacturer coupons. you must have commercial insurance to qualify. My mother is on medicare and her inhaler isnt covered. She has to use an inferior one and even that is 300/month.
So how does all of this work? Does anyone understand the savings programs, cards, patient assistance etc?