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06-27-2008, 01:33 AM
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#1 (permalink)
| | Thankful child of God
Join Date: May 2008 Location: North of Pittsburgh
Posts: 18
My Mood:  Points: 1,103.03 Bank: 0.00 Total Points: 1,103.03 |  What should I expect from my insurance?
I'm new to this and I have Health America HMO. Just being dx with PCOS and will go on Metformin in August at my next visit. Is it common for insurance to deny coverage of Met to PCOS pts or do they do it with out much complaint? Just wondering. If it isn't covered, how much is it out of pocket? Thanks ladies!! coco | 
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06-27-2008, 02:45 AM
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#2 (permalink)
| | JosieFB
Join Date: May 2006 Location: Nashville
Posts: 799
My Mood:  Points: 27,470.89 Bank: 0.00 Total Points: 27,470.89 |
If you have prescription coverage, and your doctor prescribes it, insurance normally covers it unless it is a very expensive or experimental drug. Sometimes drugs are not in the insurance's formulary, which means you will pay a higher price for it. Most insurances have a website where you can check out how much a drug will cost. Met is one of those very old generics. Most people don't pay more than $5 - $20 per month. Wal-mart and several other large pharmacies have it on their $5 list, so anybody can get it at that price with or without insurance. It is $12 per quarter under my Medco coverage. | |
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06-27-2008, 05:41 PM
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#3 (permalink)
| | Thankful child of God
Join Date: May 2008 Location: North of Pittsburgh
Posts: 18
My Mood: Points: 1,103.03 Bank: 0.00 Total Points: 1,103.03 |
Quote:
Originally Posted by JosieFB  If you have prescription coverage, and your doctor prescribes it, insurance normally covers it unless it is a very expensive or experimental drug. Sometimes drugs are not in the insurance's formulary, which means you will pay a higher price for it. Most insurances have a website where you can check out how much a drug will cost. Met is one of those very old generics. Most people don't pay more than $5 - $20 per month. Wal-mart and several other large pharmacies have it on their $5 list, so anybody can get it at that price with or without insurance. It is $12 per quarter under my Medco coverage. | That is great news! Thank you so much!!! That puts my heart at ease! I do have coverage! Now I just have to learn to eat properly so the side effects are not my undoing! Blessings, coco | |
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08-10-2008, 12:09 AM
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#4 (permalink)
| | Registered User
Join Date: Jul 2008 Location: Sudbury
Posts: 46
My Mood: Points: 2,050.59 Bank: 0.00 Total Points: 2,050.59 |
I just got my rx refilled yesterday, I'm Canada. So my prescription without coverage would have been $33.04 for 180 tabs of the regular metformin. The cost $24.07, filling fee $8.97. My co-pay was $10.94. As my year goes on, once I hit a set $ amount, my cost goes to $0. I use the Walmart for my rx. Since I am to take 2 tabs a day, this prescription will last 3 months.
Cynthia | |
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