Paxlovid is going to cost me $1400?!

[Anonymous]

Anonymous wrote:Look at paxlovid.com. Pfizer will pay most of the cost for many patients who have private insurance, and it can be free for those who are uninsured or on plans like Medicare. Two weeks ago I got the same price at CVS, and told them I wanted to think about it. Then I got in my car and called the "paxcess" helpline which coached me through the online Q&A on my phone which gave me a coupon code that reduced the price to $0. Not sure why it was necessary because my spouse who is on the same health plangot hers a week before that for a $25 co pay without doing anything extra.

Thank you, thank you, thank you!

You have helped me so much with this advice! I was able to get the discount.

For anyone saying that our system isn’t broken just tell me why it took a random internet stranger to navigate this situation while my doctor, pharmacist and insurance company never told me about this program? All of the medical “professionals” that I spoke with today just shrugged their shoulders and told me tough luck too bad so sad.

Thank you whoever you are. I am very grateful.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:What health insurance do you have?

Blue Cross but it’s a high deductible plan thanks to our generous employer who has his own yacht.

Me too and I just went to their drug cost tool and found it at Harris teeter for $5-$400. CVS was the same.

And why didn’t the insurance company rep that I was on hold with for 30 minutes tell me about that tool? Sounds like it’s the wild west and some people get lucky and others get the shakedown.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Look at paxlovid.com. Pfizer will pay most of the cost for many patients who have private insurance, and it can be free for those who are uninsured or on plans like Medicare. Two weeks ago I got the same price at CVS, and told them I wanted to think about it. Then I got in my car and called the "paxcess" helpline which coached me through the online Q&A on my phone which gave me a coupon code that reduced the price to $0. Not sure why it was necessary because my spouse who is on the same health plangot hers a week before that for a $25 co pay without doing anything extra.

For people on medicare, medicaid, and tricare, you cannot use those discounts. Either insurance covers, you private pay (we do with several medications) or you go without.

This article explains it https://www.healthcarenavigation.com/does-my-plan-cover-paxlovid/

But most insurance covers it.

My insurance will not give it to me and we have tricare. I’ve always been refused.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Our health system is completely broken. I tested positive for covid this morning and my Dr. called in an Rx for Paxlovid since I have asthma. Imagine my shock and surprise at the local CVS price of $1400!!

The medical industry is evil.

Its not broken. They are only paying if its necessary and asthma alone doesn't make it necessary.

I think I will listen to my Doctor thank you very much.

Not PP. but the issue might be that your insurance doesn't consider asthma sufficient to justify paxlovid. Insurance companies disagree with providers all the time and refuse payment.

[Anonymous]

That sucks. I got it last month and only paid $25 (I have Aetna) and used CVS. I hope you feel better soon.

[Anonymous]

Anonymous wrote:That sucks. I got it last month and only paid $25 (I have Aetna) and used CVS. I hope you feel better soon.

Thank you.

[Anonymous]

My mom had covid last summer and is on Medicare but does not have the prescription plan. Her pharmacy wanted over $800. The pharmacist recommended going to the Paxlovid site, and we were able to download a code for her that made the cost $0. I will say that she had some GI side effects with the medication, if that's something you're susceptible to, keep an eye out. They went away once completing the medicine.

[Anonymous]

Anonymous wrote:

Anonymous wrote:What health insurance do you have?

Blue Cross but it’s a high deductible plan thanks to our generous employer who has his own yacht.

Your post is misleading. Your insurance company isn't denying coverage- you just haven't met your deductible yet. This is how high deductible plans work. It's not even the choice of the insurance company-- they're legally required to make you hit the deductible before kicking in coverage.

[Anonymous]

Anonymous wrote:

Anonymous wrote:What health insurance do you have?

Blue Cross but it’s a high deductible plan thanks to our generous employer who has his own yacht.

Even with health insurance you can still qualify for a reduced price Paxlovid prescription through Paxcess.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Look at paxlovid.com. Pfizer will pay most of the cost for many patients who have private insurance, and it can be free for those who are uninsured or on plans like Medicare. Two weeks ago I got the same price at CVS, and told them I wanted to think about it. Then I got in my car and called the "paxcess" helpline which coached me through the online Q&A on my phone which gave me a coupon code that reduced the price to $0. Not sure why it was necessary because my spouse who is on the same health plangot hers a week before that for a $25 co pay without doing anything extra.

Thank you, thank you, thank you!

You have helped me so much with this advice! I was able to get the discount.

For anyone saying that our system isn’t broken just tell me why it took a random internet stranger to navigate this situation while my doctor, pharmacist and insurance company never told me about this program? All of the medical “professionals” that I spoke with today just shrugged their shoulders and told me tough luck too bad so sad.

Thank you whoever you are. I am very grateful.

NP. it was a CVS pharmacist who told me about Paxcess, so maybe they aren’t all bad. But, our healthcare system is a nightmare and I now support universal healthcare. Hope you do too.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Look at paxlovid.com. Pfizer will pay most of the cost for many patients who have private insurance, and it can be free for those who are uninsured or on plans like Medicare. Two weeks ago I got the same price at CVS, and told them I wanted to think about it. Then I got in my car and called the "paxcess" helpline which coached me through the online Q&A on my phone which gave me a coupon code that reduced the price to $0. Not sure why it was necessary because my spouse who is on the same health plangot hers a week before that for a $25 co pay without doing anything extra.

For people on medicare, medicaid, and tricare, you cannot use those discounts. Either insurance covers, you private pay (we do with several medications) or you go without.

This article explains it https://www.healthcarenavigation.com/does-my-plan-cover-paxlovid/

But most insurance covers it.

My insurance will not give it to me and we have tricare. I’ve always been refused.

Your insurance covers it if a provider orders it. You might have a deductible you need to meet, but they'll cover it after that. Prior authorization is not required, either.

[Anonymous]

Anonymous wrote:not even kidding

Mark Cuban's Cost+ Drugs is fantastic without any type of insurance

Yes
But I think they have limited items.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Thank Don the con

This is 100% on him

What a stupid and ignorant comment op said it's because they have a high deducible. This along with most things you complain about aren't related to trump. OP said, "Blue Cross but it’s a high deductible plan thanks to our generous employer who has his own yacht."

Do better.

Neither groceries nor anything else came down in price on "day one" as Don the Con promised.

DP

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Look at paxlovid.com. Pfizer will pay most of the cost for many patients who have private insurance, and it can be free for those who are uninsured or on plans like Medicare. Two weeks ago I got the same price at CVS, and told them I wanted to think about it. Then I got in my car and called the "paxcess" helpline which coached me through the online Q&A on my phone which gave me a coupon code that reduced the price to $0. Not sure why it was necessary because my spouse who is on the same health plangot hers a week before that for a $25 co pay without doing anything extra.

For people on medicare, medicaid, and tricare, you cannot use those discounts. Either insurance covers, you private pay (we do with several medications) or you go without.

This article explains it https://www.healthcarenavigation.com/does-my-plan-cover-paxlovid/

But most insurance covers it.

My insurance will not give it to me and we have tricare. I’ve always been refused.

Your insurance covers it if a provider orders it. You might have a deductible you need to meet, but they'll cover it after that. Prior authorization is not required, either.

No, that's not how it works. Your provider can order it and tricare can deny it. There is No deductible on base. Stop giving wrong advice.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Thank Don the con

This is 100% on him

What a stupid and ignorant comment op said it's because they have a high deducible. This along with most things you complain about aren't related to trump. OP said, "Blue Cross but it’s a high deductible plan thanks to our generous employer who has his own yacht."

Do better.

Oh shut up MAGA. Why don’t you and your ilk do better?