Cost of Temodar has gone up - Insurance claims it has benn reformulted

We just went to pharmacy to get Temodar and also found that Blue Cross charged us $800 for our prescription, I am now thinking- - -  this drug will break us, and so what else are they going to do to us now??? But they deducted it from our yearly out-of-pocket maximum of $1500 for the year. So next month, although it is a lot to bite off in one month, I will pay the entire yearly out-of-pocket off. This drug comes off the medical portion of the policy and not the pharmacy side they said. I had to probe to get what they meant, they don't tell you, so it did not make sense to me at all when they told me this. Since it comes off the medical side, in two months, my entire medical yearly out-of-pocket will be paid in two treatment and I am done for the entire year, then it is free. I will not have to pay anything for medical the rest of the year. So, see if they are with you too, deducting this amount from your yearly out-of-pocket, which may mean that after so much, you don't have to pay anything for medical the rest of the year. Still though, hard to believe that anyone would have to pay such horrible fees up front for these types of medications, it drains you, financially and emotionally to have to go through this. For some people it could mean they don't eat well for the entire month, it really worries me. Hope this helps, because most insurance companies do not even bother to explain to you that these high co pays on certain specialized drugs, come off your yearly out of pocket. Crazy fees for medical drugs! There are now about 7 or 8 of these special drugs that come off the yearly out of pocket in policies, so check with your insurance company. Some of the employees that work for your insurance may not even understand this, you have to get to the right person in order for them to know and be able to help you. 

We just went to pharmacy to get Temodar and also found that Blue Cross charged us $800 for our prescription, I am now thinking- - -  this drug will break us, and so what else are they going to do to us now??? But they deducted it from our yearly out-of-pocket maximum of $1500 for the year. So next month, although it is a lot to bite off in two months, I will pay the entire yearly out-of-pocket off. This drug comes off the medical portion of the policy and not the pharmacy side they said. I had to probe to get what they meant by all of this?, cause they do not explain it well, and I had the expert on the phone. They don't explain what that means, it did not make sense to me at all when they told me that it comes off the medical portion of your policy. Medical portion is such a broad term, it did not dawn on me that it meant in a couple of months you will not have to pay anything after your out-of- pocket for the year is reached. Since it comes off the medical side, in two months, my entire medical yearly out-of-pocket will be paid in two treatments and I am done for the entire year, then it is free from then on. I will not have to pay anything for medical the rest of the year. So, see if they are also deducting this amount from your yearly out-of-pocket, which may mean that after so much, you don't have to pay anything for medical the rest of the year. Still though, hard to believe that anyone would have to pay such horrible fees up front for these types of medications, it drains you, financially and emotionally to have to go through this. For some people it could mean they don't eat well for the entire month, it really worries me for people who cannot afford this. It was a hardship on us. $800 deductible is a lot of money. I hope this helps, because most insurance companies do not even bother to explain to you that these high co pays on certain specialized drugs, come off your yearly out-of-pocket maximum. Crazy fees for medical drugs! There are now about 7 or 8 of these special drugs that come off the yearly out-of- pocket in policies if you are medicare I think is how this works, so please check with your insurance company. Some of the employees that work for your insurance may not even understand this, you have to get to the right person in order for them to know and be able to assist you. The help in the insurance industry is many times not educated to all of the "ins and outs" made through Obama care. I am not positive this change came out of Obama Care, but it is highly possible.

We just went to pharmacy to get Temodar and also found that Blue Cross charged us $800 for our prescription, I am now thinking- - -  this drug will break us, and so what else are they going to do to us now??? But they deducted it from our yearly out-of-pocket maximum of $1500 for the year. So next month, although it is a lot to bite off in two months, I will pay the entire yearly out-of-pocket off. This drug comes off the medical portion of the policy and not the pharmacy side they said. I had to probe to get what they meant by all of this?, cause they do not explain it well, and I had the expert on the phone. They don't explain what that means, it did not make sense to me at all when they told me that it comes off the medical portion of your policy. Medical portion is such a broad term, it did not dawn on me that it meant in a couple of months you will not have to pay anything after your out-of- pocket for the year is reached. Since it comes off the medical side, in two months, my entire medical yearly out-of-pocket will be paid in two treatments and I am done for the entire year, then it is free from then on. I will not have to pay anything for medical the rest of the year. So, see if they are also deducting this amount from your yearly out-of-pocket, which may mean that after so much, you don't have to pay anything for medical the rest of the year. Still though, hard to believe that anyone would have to pay such horrible fees up front for these types of medications, it drains you, financially and emotionally to have to go through this. For some people it could mean they don't eat well for the entire month, it really worries me for people who cannot afford this. It was a hardship on us. $800 deductible is a lot of money. I hope this helps, because most insurance companies do not even bother to explain to you that these high co pays on certain specialized drugs, come off your yearly out-of-pocket maximum. Crazy fees for medical drugs! There are now about 7 or 8 of these special drugs that come off the yearly out-of- pocket in policies if you are medicare I think is how this works, so please check with your insurance company. Some of the employees that work for insurance companies may not even understand this, you have to get to the right person in order fto get someone who can really assist you. The help in the insurance industry is many times not educated to all of the "ins and outs" made through recent changes due to Obama care. I am not positive this change came out of Obama Care, but it is highly possible.

I get my Temodar through A mail order specialty pharmacy. It's actually owned by Walgreens though they are called Trieccant. They always overnight it UPS in plenty of time. I've never even checked on getting it any other way because this is actually more convenient than getting it at a pharmacy.

Also, Merck has a great program called Commitment To Care. Temodar is provided under the ACT devision of that program. They have very high income thresholds and will over night you the Temodar as well free of charge if you qualify.

Finally, check with your state. Many are now passing laws requiring insureres to cover oral chemos like they do IV chemos. Texas just went into affect last Sept, that's how I'm getting mine now under major medical rather than prescription drug, which covered about 1 month a year.

Grace and Peace,

Danny

My husband gets his Temodar through a specialty pharmacy through the mail. He has United Healthcare and this is the only way they will provide it. The pharmacy is Medco/Accredo. His copay for January's Temodar was $1,481 (because it was the start of a new year and his deductible). His copay last month was $10. This month it will probably be $32, as he's able to get a higher dose this time due to better blood counts.

They ship free overnight. It just comes in a UPS box, and the pill bottles are wrapped in bubble wrap. We haven't had any problems.

For any of you who do not know, check into Cancer Care Copayment Assistance Foundation. Call to see if you qualify. They ask your income and you have to have insurance. We were approved for $10,000 for the year (although we won't need to use that much of it). This is an awesome charity! I had to follow up several times to get them moving, but we received our check for $1,481 today. Now I can pay that off on our Visa. (The specialty pharmacy wouldn't ship my husband's next dose unless the $1,481 was paid up front.)

http://www.cancercarecopay.org/

Hi I just had to put my 2 cents worth in this.  My loving husband (passed away Dec 7. 2011, only made it to 9 months and two days) canceled his prescription coverage years ago because it was not worth it to him at the time.  Then he was dx with gliblastoma grade 4.  We were lucky enough that where he had his radiation and chemo the pharmacy picked up the entire bill.  Due to the fact that we were on a fixed income and we fit the category where it was paid for.  At that time and still I am a total mess so not quite sure how this all came about but someone at the  hospital  who deals with all this kind of stuff helped us out and so all his expensive meds were paid for.  So if anyone out there does not have prescription coverage please talk with your doctor/pharmacist to help with the cost of any expensive medications.  I picked up all his medications at the pharmacy hospital where he had all his health care taken care of.  I hope this helps out any of you out there.  Sorry I am so scattered brain but the loss of my husband has devastated me.  

My wife's Temodar has not gone up, however, her first prescription this year( that we pay cash for due to $10,000 deductible) the aluminum foil top was tampered with. When she took the cotton balls out there was no pills, someone had stolen them.  The were picked up locally at a Wal-greens . Luckily we know the pharmacist well, and they were replaced.

My husband receives Temodar through the mail in a special packaging.  He HAS to sign for it when it arrives and He can order it on Thursday and it will arrive by the Next Tues. (3 days at the most).  He calls and answers a few questions and they check his script and that's all there is to it.  Very Convenient but that is just our experience.

If you are going to a major hospital, you should be able to contact your social worker at that hospital who can give you information on organizations that will help you pay for these meds. I know of one, www.cancercare.organd partners for prescription assistancewww.pparx.org . There are more- you should contact these people, maybe you can get some of that money to help you pay for this.  Talk to the hospital social worker. Our social workers were miracle workers.

love Cathy ( mommy to Julia 2002-2012)GBM IV

web sites got messed up somehow (gremlins?)

www.cancercare.org    (cancercare dot org)

www.pparx.org   (partnership for prescription assistance, PPA)

sorry, Cathy