Ugh - thanks for nothin, Aetna.

mrslaquinta

So I went to refill my Zofran today and found out that Aetna will only cover 12 pills per 30 day period - what?!?  If I took them at the max prescribed dosage, that would be 6 pills per day (1-2 pills every 8 hours).  So they will cover 2 days per month of medication.  Gee, thanks. I need it to be able to function and take care of my girls some days (thankgod not every day is quite so bad!), so I just asked them to fill my remaining rx of 18 pills as self-pay, and it was $61.  For 18 pills, or 3 days!!!  Such baloney!  It's not like it's a narcotic or anything - why such ridiculous limits??  Blah - just a rant to people who get how bad m/s sucks.

*disclaimer - I know it's not Aetna as a whole, so I'm really just complaining about our stupid plan.*

Jess.O

  I'm sorry.  Although insurance has it's benefits there are certainly downfalls as well.

MrsMillerTime

MrsRosie:

Lame. I say barf in an envelope and send it to them.

Awesome.

MrsBeckO

Ugh, major suck! I had to alternate zofran and reglan (not for ins purposes), can you request something like that to have more available to you per month? Hope you feel better soon!!!

And this has me a bit worried.. Our new ins is with Aetna and I couldn't live without the meds while I was pg.

L L CG

Oh sweetie thats horrible!  I'm so sorry!  Hang in there.  I hope m/s doesn't last much longer for you!

kiarox2002

That sucks!  I've heard dramamine can help- maybe you can use it on the not-quite-as-bad days so you can save up the zofran?

FeistyFille

I so wish the people who made these policies could get a taste of what you're going through.  I'm sorry. 

Taytee

That's no fair and no fun.

Try taking half doses when you can. Sometimes it's just enough to take the edge off, especially if you take the next dose before the previous one wears off. So try full dose first thing in the morning if you need it, then take a halfsie dose on schedule for the next dose. It's easier to supress nausea than it is to relieve it (just like pain).

Did your doctor write for "Generic OK" ? Your insurance may be being a butthead if you're only gettting brand name. Zofran is pricy, Ondansetron can be more reasonable sometimes. Just something to look into!

Why is it so expensive? Because they can. Basically. There are so few drugs for nausea and vomiting.

carlinlp

Ugh, I'm sorry   That happened to us with #3.  It ended up being about $600+ a month.  I had more than one cry on the phone with them begging for help. 

I personally love the idea of throwing up in the envelope.  I wish I woulda done that.

molliedb

The ER doc who gave me iv fluids when sick as a dog with eve gave me a great tip. Med savers pharmacy on 38th fills prescriptions without insurance at super reasonable rates. I think my zofran (which they filled with the generic) cost about $40 per month there.

Taytee

molliedb:

The ER doc who gave me iv fluids when sick as a dog with eve gave me a great tip. Med savers pharmacy on 38th fills prescriptions without insurance at super reasonable rates. I think my zofran (which they filled with the generic) cost about $40 per month there.

mrslaquinta - Let me know if this works out for you so I can tell patients!! I totally called CVS on the down low last night for you and asked how much Generic Zofran is (4mg ODT, 18 count) and they said $108 ?! HolyShitBalls!!! I know most of our patients can't afford that so I'd love to have a reasonable place to send them.

PMBridetobe

 Have you tried a letter of medical necessity from your doctor?  Our insurance only gave DH 1 pill a day on a med that the doctor had prescribed 2 a day.  They had to fill out some paperwork but now he can get what the doctor ordered.

Also, I priced it using hte PS Card and for the generic it is $42 for 30 4mg pills.

https://www.pscard.com/searchAndCompare.cfm

Kitkatishbakk

You may want to try through Aetna's mail order pharmacy. I know they would only cover 15 days of my meds through a reg pharmacy, but if I ordered it through them, I would get 90 days for the same price as 15 days at CVS.

molliedb

Taytee:

molliedb:

The ER doc who gave me iv fluids when sick as a dog with eve gave me a great tip. Med savers pharmacy on 38th fills prescriptions without insurance at super reasonable rates. I think my zofran (which they filled with the generic) cost about $40 per month there.

mrslaquinta - Let me know if this works out for you so I can tell patients!! I totally called CVS on the down low last night for you and asked how much Generic Zofran is (4mg ODT, 18 count) and they said $108 ?! HolyShitBalls!!! I know most of our patients can't afford that so I'd love to have a reasonable place to send them.

 

oh it works!  i have filled zofran there through two pregnancies now.  they don't take or ask for insurance and their prices are on their website.  totally up and up.

https://www.medsaversrx.com/

 

right now their price for zofran is:

Zofran (Ondansetron) 8mg ODT

30

$55.92

 i also got the 8mgs and cut them in half, so this is 60 4mg pills for $55

 

mrslaquinta

Thanks, ladies - good tips! Mollie, I will definitely be going to Medsavers next time, as my dr's office is right there, anyway.  So good to know - thank you!

mlf625

That's ridiculous.    And I feel your pain, I'm SO annoyed with Aetna right now, too.  They're refusing to pay for any of A's speech therapy and saying the ~$750 (so far) is 100% our responsibility.  Awesomeness.

mrslaquinta

mlf625:

That's ridiculous.    And I feel your pain, I'm SO annoyed with Aetna right now, too.  They're refusing to pay for any of A's speech therapy and saying the ~$750 (so far) is 100% our responsibility.  Awesomeness.

Blech. That bites. Sorry you're dealing with that headache!!  Aside from that, how is the speech therapy going?

Mainer-in-Texas

That is so freaking annoying. I switched to Aenta when I left my job last summer, and so far I am not the biggest fan. They tried to drop me like a hot potato the second they got a bill from CF clinic - I got a letter saying, "If you don't provide proof of previous insurance w/in 30 days, we aren't going to cover you." And I've had a similar problem getting Diflucan covered - I've been on antibiotics for two months and keep getting YIs, but they will only cover one pill a month, so I guess they expect me to feel better for a week and then spend three weeks in misery :P

michelleaxo

Hope you are feeling better soon!