7 replies to this topic

[SueC]

Does anyone else on here have MI Blue Cross.  I recieved a call from my Pharmacist today and for 3 years I have had to pay $40 a month for my gleevec.  Today they called and said they could not fill it because Blue Care Network will only pay  $4000 or something close to that and I have to pay the rest, which at that particular pharmacy is $2140 HMMM  x 12 = $25,680 PER YEAR FOR ME TO PAY.   Hee Hee Hee that is simply hilariuous since I do not even make that in a year!!   UGH!!!  I can't call Blue Cross till 8:30 am tomorrow God I hope it is a mistake!!!!

Anyone else in Mi have Blue Cross???

Sue

[lala]

Hi.....I don't have your insurance, but my gleevec costs about $4600 month.....soooo expensive but less than yours.....hopefully your insurance info is wrong------and you can find it at a cheaper price.  I am in Illinois.  There are people on this site that get it in the mail which is cheaper, I would guess.  I wish you luck in the morning.....last January, they refused to pay for my G.  We got it settled but after many tears!  Good luck....let us know how it turns out.  Lala

[Susan61]

Hi Sue:  I hope you get some answers.  I do not have Blue Cross, but I would be on the phone with everyone on Monday.  I have Aetna Ins. and have not had any trouble.  My Gleevec does come mail order, and I have my co-pay for 90 day supply.  My co-pay is $80.00.

If you do not resolve this pricing, then get in touch with Novartis.  They are very good about helping with the cost.  I have gotten help from them.

Good Luck and Let us know how you make out.

Susan

[CallMeLucky]

You need to find out if it is Blue Care that cut it or your employer.  If your employer is self insured, then they are in control of the coverage, if it truly is an insurance policy then you will have to deal with the insurer.  It would be odd for them to simply cut coverage mid-year, but anything is possible.  If it is the insurer then you have to get the details behind it and contact your local state insurance board.  Some states are now wrangling with legislation that would require insurance companies to cover oral chemo the same way they do intravenous.  I don't know about MI, I believe there was a bill at one point but couldn't find out any details.  So again, contact the state insurance board and find out.  If it is true insurance, they have to follow state law, if it is self insured, they have more freedom to do what they (your employer) wants.

I hope they just made a mistake.  Good luck.

[Happycat]

Sue,

I have Blue Cross MA, and the list price for Gleevec is $5000 per month, so your pharmacy's price seems rather high to me.  Please let us know what you find out, since I'm sure many here are interested!  Good luck.

Traci

[SueC]

Finally cleaned up this whole ordeal with Blue Care Network.  It appears that they needed to speak to me since it has been 3 years and verify i was still taking the drug.  Then they had to provide my pharmacy with an override code for the RX.  Sounds simple except it took 4 days UUGGHH!!!  I think I may have stressed just a bit the last few days   Glad it is worked out.  BCN used this chance to appeal to me to use the mail order RX as it will save me some money and I am sure it saves them alot of money.  I am just nervous since I am on a rural route and the mail is left at the box at the street.  if a package gets lost who is responsible??  I really don't want to take that chance.

Thanks for all the input!!

Sue

[CallMeLucky]

Glad it is resolved.  My Rx comes mail order.  They don't send it USPS, they send it FedEx and if I want they will send it with signature required, which means FedEx has to come to the door.  During extreme seasons they ship in sealed containers with ice packs in summer or other packing to keep warm when cold out.

[nathaliece]

Sue,

I get my Gleevec from Diplomat Pharmacy which is a mail order and they mail it to my office and require someone to sign for it so that it does not get lost.  They call me each month and we agree on the day it should be delivered.  It has worked very smoothly.

Nat