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Insurance and Long Term Azithromycin Question


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We are switching to United Healthcare in a couple months but it is a high deductible major medical policy. We are currently with a Cigna PPO which charges only a copay for long term Azithromycin. When we switch over we will be on the hook for the entire cost of the prescriptions until the deductible is met. My question is how to get long term Azithromycin prescribed and filled in a situation like this. Can you get longer prescriptions than a few days at a time? We are currently using a suspension.

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We are switching to United Healthcare in a couple months but it is a high deductible major medical policy. We are currently with a Cigna PPO which charges only a copay for long term Azithromycin. When we switch over we will be on the hook for the entire cost of the prescriptions until the deductible is met. My question is how to get long term Azithromycin prescribed and filled in a situation like this. Can you get longer prescriptions than a few days at a time? We are currently using a suspension.

 

I don't know if your insurance is exactly the same...but we have United Health Care PPO.

 

This year, for some STRANGE reason, our copay on rx's is $0. We don't have to meet our deductable for the prescription benefit. It seems like the prescription benefit (at least for us) is separate from the expenses (other medical expenses, office visits etc) that require a deductable. (Does that make sense?).

 

We get Azith. 250mg tablets #60. The rx says 2/day, but we actually (normally) only take 1/day.

 

I don't know how it would work with liquid, since I believe once it is reconstituted, you have to use the Azith. within a certain amount of time (10 or 14 days?). Unless they give you a month's worth, and some are the bottles are not mixed with water yet (for you to mix at home).

Edited by EAMom
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We Weill no longer be with a PPO so we have to pay the entire cost of the prescriptions until the deductible is met. Just trying to figure out how to ask for it to be prescribed. If they will fill 60 at a time we may have to try that and work on swallowing pills.

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Well if you are are as unhealthy as we are, you can have that maxed out in a few months --- and then just dodge the mailman when the hospital bills arrive. :) Kidding!

 

Hmmm, I wonder if mail order prescriptions will be cheaper for you. I know some of them are like buying two months and getting the 3rd free (but this is usually based on copay/insurance) -- maybe they do something like that too. Perhaps call the insurance company and ask.

 

Otherwise, talk to the doctor and explain. See what they recommend. Some may work with you a bit, it's tricky for them though, because they have to put the dosage, etc. on the script and legally they can't really alter that.

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For a long time, we had to pay cash for azithromycin and it can be VERY expenive - it was $400 per month at CVS for either 250 mg once per day or 250 mg twice per day -- I forget which. However, at Costco, it was only about $120 per month, and the last time they filled it, they used Z-Packs and that brought the same prescription down to about $60 per month. I strongly suggest using costco (perhaps they will fill it from their internet site if there is no costco near you) and ask them to fill it using Z-Packs. This is for tablets -- don't know about suspension, but I taught one child to swallow pills at age 5 and the other at age 7, so it can be done, if necessary. We practiced with swallowing small candies, then moved on to M&Ms.

 

You can also call around pharmacies and ask what their cash price -- no insurance -- is for a specific dosage. They can vary enormously in price.

 

Good luck!

 

 

 

We are switching to United Healthcare in a couple months but it is a high deductible major medical policy. We are currently with a Cigna PPO which charges only a copay for long term Azithromycin. When we switch over we will be on the hook for the entire cost of the prescriptions until the deductible is met. My question is how to get long term Azithromycin prescribed and filled in a situation like this. Can you get longer prescriptions than a few days at a time? We are currently using a suspension.

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I have high deductible insurance as well. My child doesn't take Azith so we're not expensive, but we go Target every 10 days for a new bottle. Call around to various phamarcies since pricing will vary.

 

We also pay for the full 30 days script, but go every 10 days for a new bottle. They write on the bag "bottle #1", "bottle #2", etc.

 

I didn't realize this was the concern, I was thinking along the lines of trying to get the dr. to prescribe more meds than needed for the month to save on cost. Figured that would be a big issue. BUT, what you are saying is common I think. I've even had multiple times the pharmacies run out of stuff and I have to come back for the rest of it later on. It should not be an issue for you to go back to pick up the balance due on your script if that was the worry. Sorry, I must have misunderstood.

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