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The Cost Of Med's...wow..


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#1 stardust

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Posted 12 June 2009 - 04:34 PM

I've been taking Xyrem for 1yr this past January. I was reading what some people where saying about the cost of medication.. I didnít know it cost that much! I mean my insurance helps a little, but I'm still looking at roughly $1,000 a month. I don't know what I'm going to do once I have to start paying that bill by myself. The Lords helped me a lot so far cause my parents have been able to pay it, but I don't want to think about when I graduate from college. Then I'll no longer be under my parents insurance. Is there anyone out there headed the same way or has been in the same boat before? Cause I could use all the money saving tips you can give. I'd like to laugh about it right now, but I don't see how...

#2 drago

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Posted 12 June 2009 - 06:25 PM

QUOTE (stardust @ Jun 12 2009, 10:34 PM) <{POST_SNAPBACK}>
I've been taking Xyrem for 1yr this past January. I was reading what some people where saying about the cost of medication.. I didn't know it cost that much! I mean my insurance helps a little, but I'm still looking at roughly $1,000 a month. I don't know what I'm going to do once I have to start paying that bill by myself. The Lords helped me a lot so far cause my parents have been able to pay it, but I don't want to think about when I graduate from college. Then I'll no longer be under my parents insurance. Is there anyone out there headed the same way or has been in the same boat before? Cause I could use all the money saving tips you can give. I'd like to laugh about it right now, but I don't see how...


You should talk to your parents about taking up COBRA for yourself. I'm doing that now with my parent's insurance because it has better coverage than I can hope for.

drago

#3 Marcianna

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Posted 12 June 2009 - 09:35 PM

QUOTE (drago @ Jun 12 2009, 11:25 PM) <{POST_SNAPBACK}>
You should talk to your parents about taking up COBRA for yourself. I'm doing that now with my parent's insurance because it has better coverage than I can hope for.

drago


interesting... tell us more about COBRA? I have not heard of this before.

#4 Lais02

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Posted 12 June 2009 - 10:08 PM

I'm in the same boat. I take Xyrem and I won't be able to keep my parent's insurance after this summer. I still have no idea what I'm going to do.

#5 jenji

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Posted 12 June 2009 - 10:46 PM

Hey Stardust and Lais:

Needymeds.com could give you some direction and/or assistance. Here's the link for Xyrem in particular...
http://www.needymeds...u...&name=Xyrem

jenji

#6 drago

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Posted 13 June 2009 - 02:29 AM

QUOTE (Marcianna @ Jun 13 2009, 03:35 AM) <{POST_SNAPBACK}>
interesting... tell us more about COBRA? I have not heard of this before.


Well, I'm not sure I'm a great source for it, but if you search for "COBRA health insurance" you get quite the return.

http://www.dol.gov/e...umer_cobra.HTML

This enables you to continue your coverage specifically when you lose your job, but it also enables you to extend benefits to children who no longer qualify as students.

You'll have to have your parental unit(s) chat with their benefits office/human resources/the person who is in charge of this info at their job about their COBRA info specifically.

drago

#7 Irishhh

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Posted 13 June 2009 - 01:40 PM

OMG no. Don't do COBRA, it is such a piece of crap.

Do you know you can purchase health insurance on your own?

www.ehealthinsurance.com

#8 drago

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Posted 14 June 2009 - 12:34 AM

QUOTE (Irishhh @ Jun 13 2009, 06:40 PM) <{POST_SNAPBACK}>
OMG no. Don't do COBRA, it is such a piece of crap.

Do you know you can purchase health insurance on your own?

www.ehealthinsurance.com


It depends on your insurance plan before you get COBRA.

You can buy your own health insurance, but prescription coverage can be ridiculously costly. Again, depending on your past coverage.

drago

#9 Irishhh

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Posted 15 June 2009 - 10:59 AM

QUOTE (stardust @ Jun 12 2009, 05:34 PM) <{POST_SNAPBACK}>
I've been taking Xyrem for 1yr this past January. I was reading what some people where saying about the cost of medication.. I didn't know it cost that much! I mean my insurance helps a little, but I'm still looking at roughly $1,000 a month. I don't know what I'm going to do once I have to start paying that bill by myself. The Lords helped me a lot so far cause my parents have been able to pay it, but I don't want to think about when I graduate from college. Then I'll no longer be under my parents insurance. Is there anyone out there headed the same way or has been in the same boat before? Cause I could use all the money saving tips you can give. I'd like to laugh about it right now, but I don't see how...



Cobra is basically a fill in while you are waiting to get another insurance anyway. Why not go ahead and be looking now for a new insurance provider? Try the website I sent you and you can find a plan and go ahead and sign up, but not have the coverage start until the day yours ends from your parents.

My parents had awesome insurance, and my cobra was going to be roughly $1000 itself. My dad's insurance paid for anything and everything pretty much. My mom is under a lot of medical care, and he has an account that helps pay into that as well. Anyway, from my exp w/ Cobra, and from my current place of employment, it is a rip off.

Once I figured out that it would cost be aroung $1000, i started looking around. I got a plan for $100. Of course they started trying to add on charges because I took antidepressants, etc.

I ended my coverage with them and have yet to sign up anywhere else.

I need to...

Find out now how much cobra will cost you and then check into other plans. You can purchase on your own the same way a company would purchase for you, except with this you'll be paying it all yourself.

Don't forget though, there are fees for doctor visits, prescriptions, etc. Plus there may be time limits before you can use certain things your insurance provides. Plus there is always that deductible thing. Make sure you ask a lot of questions about the deductible. What yours is, what of your expenses are put toward your deductible, blah blah blah. Get as much information as you can and don't be surprised if they try to change it on you! Insurance can be evil.

Good luck!!!

#10 drago

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Posted 15 June 2009 - 12:39 PM

QUOTE (Irishhh @ Jun 15 2009, 04:59 PM) <{POST_SNAPBACK}>
Cobra is basically a fill in while you are waiting to get another insurance anyway. Why not go ahead and be looking now for a new insurance provider? Try the website I sent you and you can find a plan and go ahead and sign up, but not have the coverage start until the day yours ends from your parents.

My parents had awesome insurance, and my cobra was going to be roughly $1000 itself. My dad's insurance paid for anything and everything pretty much. My mom is under a lot of medical care, and he has an account that helps pay into that as well. Anyway, from my exp w/ Cobra, and from my current place of employment, it is a rip off.


Again, with COBRA, it depends on the insurance in question. I have a "very good" insurance (according to my doctors) a PPO plan with prescription coverage for around $400/mo. I'd be looking at paying around $450-550 for the same coverage from other plans. So it worked out well for me. But, some plans are VERY expensive - and COBRA itself wouldn't change that at all.

I believe COBRA was originally set up for people who were fired/laid off/otherwise lost their jobs, but wanted to maintain their same insurance plan either at their new job or unemployed. So it's not necessarily meant to be temporary.

QUOTE
Don't forget though, there are fees for doctor visits, prescriptions, etc. Plus there may be time limits before you can use certain things your insurance provides. Plus there is always that deductible thing. Make sure you ask a lot of questions about the deductible. What yours is, what of your expenses are put toward your deductible, blah blah blah. Get as much information as you can and don't be surprised if they try to change it on you! Insurance can be evil.


Yes - I agree with Irishhh on this - check all your options before you commit. Also, be sure to ask about prescription coverage on everything - including Formulary! Generic and Name-Brandbrand co-pays are often flaunted, but the formulary price can be ridiculous... and often it comes up in tough cases. Like I needed to fill my antibiotic prescription that I got from the emergency room, and the particular type of antiboitic was a formulary and cost me a $50 copay instead of the $10. Of course, the doctor I saw was an emergency doc, and I needed to start the antibiotics to feel better, so I didn't have a lot of options. :-\

Also, check out the "co-insurance" policy. I had a deductible on my plan as well as a co-pay. When the deductible was finished, I just pay the co-pay... until I pass a certain amount, then I pay an additional "co-insurance" (10% of the doctor's bill) on top of my co-pay. This happened when I did my sleep study. sad.gif So check out all the policies before committing, especially as a narcoleptic person who might get tons of random charges slammed into them.

drago

#11 Henry G

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Posted 16 June 2009 - 03:01 AM

As stated earlier, there is no reason why Xyrem should be so obsenely expensive.

Is it patented or something?

Apparently it is so stupidly cheap to produce, the cost of manufacturing would be something like $10 a gallon.

#12 stardust

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Posted 29 June 2009 - 12:53 PM

Oh my goodness you guys.. I totally didn't expect for that many people to respond. I was just hoping for one, but wow. =) This makes me happy.. because it means I really do have a voice up here. Sorry I'm totally new at this whole Narco.Net.Com. thing. Oh, thank you so very much for responding. I don't know if you guys know how good this makes me feel.
I don't think I stated clear enough how utterly clueless I am when it comes to insurance and all that. I feel ashamed saying that.. but its the truth. The truth will set you free right.?.
Yea, I'm going to copy and past all those websites you guys have sent my way and see where they'll take me. Heck, I mine as well print this whole topic along with every piece of advice you all toke the time to send my way. Thank you again.

Stardust



#13 Mike M

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Posted 03 July 2009 - 11:05 PM

Is it patented or something?


Henry, I believe that the expense is a direct result of two things. One, of course, is the patent that Jazz (formerly Orfin) holds. The other is that Xyrem is a massively controlled substance. Jazz has a massive "program" to support and help PWNs manage their use of Xyrem. Jazz is not only the sole company that makes Xyrem, but also they are the sole PHARMACY distributing the drug. It truly gives an entirely new meaning to monopoly. Xyrem is literally FedEx-ed to PWNs. Gotta love U.S. laws!

#14 Mike M

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Posted 03 July 2009 - 11:08 PM

Oh, thank you so very much for responding. I don't know if you guys know how good this makes me feel.


Stardust, one of the best things about these forums is that most of us have been in your position at one point or another. Thank you for asking a difficult question. Also, please note how many other people you helped by asking your initial question. Finally, I wanted to point out that depending on what happens after college, you might wind up getting insurance through an employer. I hope everything works out. Please keep us all posted.

#15 Jesse

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Posted 07 July 2009 - 10:45 AM

stardust, I'm sort of in the same boat as you - having trouble affording Xyrem. I have decent insurance that covers 70% of the cost, but that still leaves me with a copay of around $400-$450 a month (if I take my prescribed dosage). I haven't taken the full dosage for awhile now, as I was trying to stretch my supply out as long as possible. I'm almost down to the bottom of my last bottle and can't afford to order any more right now, so I decided to try experimenting going off the Xyrem for a few days. So far I'm doing a lot better during the day than I had anticipated I would - not expecting that to last much longer though.

I know NORD used to administer a patient assistance program for Xyrem, but I read somewhere recently that it has since been discontinued. I spoke with the distribution pharmacy yesterday and they now have an assistance program themselves - I don't know all the details, but they said if you have insurance and your copay is over $300 then the program will cover $150 of your copay for you. My copay (with the recently increased cost of Xyrem) was going to be ~$559, so with the assistance program it brought it down to ~$409. I'm not sure if the same thing applies for people with no insurance at all, or if maybe they'll cover more of the cost for people that don't have any insurance. Couldn't hurt to give them a call and ask them about it and see what they say!