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Health ins "upping" a med into highest tier pay when you need it to live? (USA)

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Lyme Disease
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Posted 6/24/2024 10:00 AM (GMT -5)
***Probably applies to USA insurance Rx coverage only***

My Rx has three tiers of coverage, prob some type of percent . The higher the tier, the less they discount, the more you pay.

I dont understand how they can jack up my desiccated pig thyroid into the highest tier when I need it to function. Its not an option. The price itself skyrocketed and then insurance covered less % on top of it. Used to be cheap per month, now its like a cheap used car payment.

Before I call them to discuss- do you have any ideas on how I should do this, what to say ect?

NP pig thyroid is also certified gluten free which I need- other brands wont disclose info on this. T4 only is ineffective for me- I cant function/work in society on it.
Posted 6/25/2024 12:08 PM (GMT -5)
I checked mark Cuban's costplus and it looks like they don't carry it right now. Goodrx looked expensive still. I went to needymeds.org and it looks like they have a program you might be able to apply for help from? https://www.abbvie.com/patients/patient-support/patient-assistance/eligibility-criteria.html

Sorry I don't have other ideas.

Oh sorry I just also saw you were looking for a gluten free version. There's this great nih database that in theory should include all fda approved drugs where, for the most part (I think legally they have to) they disclose all active and inactive ingredients of fda approved meds. I use it a lot to research drugs for my mcas. https://dailymed.nlm.nih.gov/dailymed/index.cfm. I use the advanced searched and tell them not to include entries with whatever allergens I'm tryin to avoid.

Post Edited (Bailey) : 6/25/2024 10:22:14 AM (GMT-8)

Posted 6/25/2024 2:39 PM (GMT -5)
Sometimes local pharmacies have their own care plan similar to goodrx - sometimes better sometimes not.

I’d also give the manufacturer a call and explain the situation. That you need it to function but can’t afford it with this change. See what they offer.
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