High copays

[ZakMeister]

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What are some of the crazy reasons patient has high copays besides a drug being in higher tiers, or not in network pharmacy or high deductible??

Patient with AARP part D plan came today with a recently renewed plan and she has an amazing $240 copay on her lantus. She claims she doesnt have deductible plan so i was confused too. I referred her to the insurance agents but i wished i knew firsthand what was up. Any thoughts?

 

[pezdispenser]

Probably needs to get Levemir or Basaglar, because Lantus is not the preferred brand for her plan.

 

[rcodyfb16]

Donut hole if part D

 

[maria1oh]

Sounds like medicare coverage gap

Refer them to walmart for cheapest price on insulin.

 

[Abby Atwood]

Sounds like medicare coverage gap

Refer them to walmart for cheapest price on insulin.

Novolin N is very inexpensive at Walmart; however, I think Lantus would be about the same price. It may be reasonable for the patient to transition to Novolin N temporarily, but I would encourage the patient to reach out to their provider to assist with the transition.

She may qualify for patient assistance through Sanofi if she is at or below 250% FPL.
http://www.needymeds.org/brand-drug/name/Lantus

FPL:
Poverty Guidelines
If she lives in a 2 person household, she would likely qualify if income is < $40,000 per year.