Prescription Insurance Change

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MountainReader

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This is just a bit of venting.

So I received a letter from my insurance this week. They are changing prescription coverage for allergy medications. As of January 1, all allergy medications will be Tier III. This means my Allegra will be going up to a $50 co-pay monthly. The only medications that will remain at Tier I will be Claritin and Zyrtec. Claritin has never done anything for me and while Zyrtec helps some, it isn't as effective as the Allegra has been. It really frustrates me that even the generic versions of the other allergy medications are at the highest levels of coverage. The best I can hope for right now is that I'm far enough along with immunotherapy that my allergies don't get worse with the switch to Zyrtec. For some reason, Allergra has been my go-to allergy medication for years in corabination with Singulair.

I'm grateful for insurance, but I hate that so many of the most effective treatments are not covered or are unaffordable. I'm 5 months into Xolair shots as well for allergic asthma and couldn't get insurance coverage for that either despite repeated appeals by my ENT/Allergist. I got 1 year of coverage from a foundation grant but won't have access to that even after 7 more months. 1 year of shots once a month--12 shots--runs about $10,000 so I can't afford it at all when my grant runs out.

I hate to think what other changes may be coming. I'm on other medications that have OTC equivalents that don't work for me either. It is very scary and frustrating.

Thanks for listening.
MountainReader
 
You know, my mother has to have the name-brand version of her blood pressure medicine because she's allergic to the generic (broke out in hives the week she tried to switch). She managed to get it covered, even though they normally don't cover any brand drug with a generic equivalent. I know they didn't approve the Xolair, but that's an extraordinarily expensive treatment. They might go for something a bit more modest.
 
You can get it for about half that from Canada. And it's available as a generic there.
 
Fexofenodine is otc in Canada, you can get the generic much cheaper than that, try an online search
 
Thanks for all your suggestions. I'll definitely be looking into those routes.
 
Its also generic and OTC in Australia, several online pharmacies sell packs of fifty tablets for about 30 Aussie doaars, if you brought several to make the postage economical, it might be a goer.


BTW, when you buy your Zyrtec, have a look at the Costco brand, 365 tablets for 20 bucks...... even if you ended up taking 2 a day to control your allergies (this isnt uncommon) it would still be cheap. I actualy buy them from America because they are about 1/10 the cost of anything I can get in Australia.
 
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