If your child is/was on Augmentin XR, was it covered by ins?

[monarchcat]

I'm still trying to figure out the whole generic augmentin vs. XR thing. I am not comfortable with ds being on 2000mg/day of augementin, thus getting 500mg of clav. I would like to go to the XR, but I understand there is a snowball's chance in heck of getting it covered by insurance (and it's really expensive). So my question is, for those using it, or have used it in the past, was it covered? Did you pay out of pocket? How much was it?

 

My pharmacist said at his dose it would be $300/month. I looked online and came up with $250, but still too expensive really. Not sure how we would swing that.

[MomWithOCDSon]

I'm still trying to figure out the whole generic augmentin vs. XR thing. I am not comfortable with ds being on 2000mg/day of augementin, thus getting 500mg of clav. I would like to go to the XR, but I understand there is a snowball's chance in heck of getting it covered by insurance (and it's really expensive). So my question is, for those using it, or have used it in the past, was it covered? Did you pay out of pocket? How much was it?

 

My pharmacist said at his dose it would be $300/month. I looked online and came up with $250, but still too expensive really. Not sure how we would swing that.

 

Yes, ours is, though at the higher, non-generic co-pay level. We have a BCBS PPO plan, and my co-pay for the XR was $50 for a full month's supply.

 

Interestingly, the co-pay is the same, whether the doctor writes the script for a 10-day, 2-week or full month's supply, so I ask for the largest/longest prescription she feels comfortable providing!

[momaine]

I'm still trying to figure out the whole generic augmentin vs. XR thing. I am not comfortable with ds being on 2000mg/day of augementin, thus getting 500mg of clav. I would like to go to the XR, but I understand there is a snowball's chance in heck of getting it covered by insurance (and it's really expensive). So my question is, for those using it, or have used it in the past, was it covered? Did you pay out of pocket? How much was it?

 

My pharmacist said at his dose it would be $300/month. I looked online and came up with $250, but still too expensive really. Not sure how we would swing that.

 

 

Our insurance covers it but at the higher non-prefered rate of $60 per month. Normally we pay $15 for generic and $30 for brand.

Angela

[EAMom]

It sounds like Augmentin XR is about as expensive as Azith.

 

Originally our HMO would only cover 5 days /mo. of Azith...we were on our own for the other 25 days. But then we were able to file an exemption to eventually get all 30 days covered.

 

The PPO we have now doesn't care...all 30 days are covered for $5.

[Worried_Dad]

We have BCBS PPO, too, and the XR is covered, but it is quite expensive as you indicated. Our latest refill was $46.54 out of pocket for 21 days. (I have NO idea why Dr. K wrote the script for 21 days at a time... but he did.)

[monarchcat]

Hmm... I may have spoken too soon! I checked our insurance (stupid of me not to check in the beginning and just take the ped's word that ins wouldn't cover XR) and it seems that it will be covered at a rate of $41/month or $100/3 months (mail-away). Sounds like a bargain deal to me! My ped just wrote a script for 3 months worth of XR with 3 refills on it. *happy dance*

 

Now I feel like an idiot for not checking into it originally.

[matis_mom]

Hmm... I may have spoken too soon! I checked our insurance (stupid of me not to check in the beginning and just take the ped's word that ins wouldn't cover XR) and it seems that it will be covered at a rate of $41/month or $100/3 months (mail-away). Sounds like a bargain deal to me! My ped just wrote a script for 3 months worth of XR with 3 refills on it. *happy dance*

 

Now I feel like an idiot for not checking into it originally.

Good idea! Dr. Latimer just gave us a prescription for XR with two refills, I'm going to call the insurance and see what would be the best deal... when we started this whole thing they actually called us to see if we wanted to take advantage of the mail-in plan (they were probably freaking out at all the stuff we were filing), but at that point we were not settled on an antibiotic/dose. Hopefully they'll work with us so it works out best for everyone. I also have to get on the ball and see if they will cover Dr. Latimer at the in-network rate, since I doubt they have any pediatric neurologists with PANDAS experience in their network. But I have to say, I am VERY happy with CIGNA so far. Thank God for medical insurance!