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[personal profile] alexxkay
So last night, I go to the pharmacist with my new Nasonex prescription. It takes a total of 30 minutes and three separate phone calls to get their computer system to recognize that I *have* insurance, but this eventually does happen.

Then I am told that, even with insurance, this drug would cost me $81.60. I'm very tired and frustrated at that point, so I say screw it, and go home.

Checking the insurance web site today, I see that they agree that this "Tier 2" drug will run me $81.60. I check the handouts from the recent presentation on our new plan. "Tier 2 - Retail Pharmacy - $30 copay". Grrr. I talk to our HR person, and she promises to track down what's going on...

The *last* time I saw an allergist was about a dozen years ago, and never got followed up on because of a health insurance meltdown I had around that time. I really hope history isn't repeating itself here.

(no subject)

Date: 2007-04-13 05:08 pm (UTC)
From: [identity profile] hascouf.livejournal.com
Ok, some insight from an appeals analyst that has worked at 2 major hmo's in MA for the last 10 years

From what they can find Nasonex has a generic - if your prescription didn't say no substitutions, they you get that generic at the appropriate copay (usually Tier 1), if you insist on the brand name, you pay Tier 1 copay + retail difference between generic and name brand.

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Alexx Kay

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