COVID uncovered my COPD, scared and Insurance won't pay for trelegy.
2 years ago my anual CT scan detected mild to moderate emphysema. It realy didn't effect my life much. I just carried on as normal. 3 months ago I got COVID pretty bad to the point that I had to call my PC. He prescribed 3 meds and within 10 days I was better but not 100%. My lungs remained congested, my smell and taste was shot, my migraines started raging again. I had my annual check up last week . I told him about my issues and add these bouts where I couldn't catch my breath from doing simple things like bending over or laying down.(its scary). He informed me of 2 things. I had COPD and that I have long haul COVID. He advised me to quit smoking. I did immediately and haven't had a cigarette since. He wrote a script for trelegy but warned me that Medicare and Aetna normally deny it. Sure enough I got a call from my pharmacy a hour later with the bad news. DENIED! but for $708 I could buy it out of pocket and there is no generic. I spent the entire weekend looking for assistance, coupons, direct discouts from the manufacturer. The best that I came up with is a $15 coupon. I don't have $700 of disposable cash laying around. Sadly I did find out how corrupt our Healthcare system is. I checked out Canadian pharmacy. For a 90 day supply of trelegy its $500. Huge difference! I'm the process of shifting money around to try to get the medication from Canada. In the meanwhile I've also been reading alot about Mullien and it herbal benefits, it may not help but it doesn't appear to hurt you either so I've order that also. I've started reading through this forum which is helpful. Admittedly I'm scared and in uncharted waters. It doesn't happen often, but on those occasions when I can't catch my breath, I've learned not to panic and just try to breath. On a good note it easy to quit smoking when your scared. At the same time Im a full time caregiver for my wife so I can't afford to be down. I guess I had to just get that of my chest no pun intended. But Im really pissed at our Healthcare system right now when I need it the most.
How absolutely maddening and unfair,
. Unfortunately, most pharmacutical companies are still not allowed to negotiate with the government to lower prices for people on Medicare. If you were not on Medicare, you might qualify for assistance that covers all or part of your costs. There is one more option you can try: The PAN Foundation. Their grant eligibility varies, so you can check back in a few months if they can't offer you assistance now. Here is a link: https://www.panfoundation.org/. You can also ask your doctor is there is another medication that might help. Please know we are here for you. Best of all wishes. - Lori (Team Member) ,
I am enrolled in the Prescription Assistance Program thru my local county hospital. They do all the paperwork and act as a go between for me. It costs me 15 dollars a month for my inhalers. I started out with Symbicort and am now on Bevespi. I have no prescription insurance, so this is most likely why I was accepted into the program. Have you contacted GSK, the company making Trelegy? They offer assistance in affording your medication. There is contact information on the website for Trelegy for this purpose. Although with active prescription insurance, it is most likely to be denied. My pulmonologist told me if I could not afford my inhalers or get assistance, that his office would provide samples for me to get by on until such time as I could get assistance in affording them. Assuggested above, ask your doctor to change to another inhaler. One that maybe will be covered by your insurance. My wife was denied by her insurance for Breztri (she has asthma), but was ok for her to get Symbicort. She still works and I am retired. I have Medicare A&B, but opted out for prescription coverage. I get better prices with Good RX and Single Care. Also Walmart gives 60% discount for AARP members on all prescriptions. This probably doesn't help you much, but I thought I would throw in my 2 cents worth anyways. Take care and God Bless! there is the crazy part, because I do have medicare prescription coverage through Aetna, I don't qualify! So I'm a hostage to thier DENIAL. I'm going through the process with the manufacturer now but Im not optimistic. Ultimately once I scrape up the money I will probably end up buying my prescription from Canada for a far more reasonable price. If nothing else this should enlighten people about how bad our "For Profit" Healthcare system is. Think about it $708 locally best price for 30 days. Canada $500 for 90 days. Thats a insane mark up! And under the present political climate I fear it will get horribly worse. People are going to die a slow painful death, and I may be one of those statistics. My household medical costs are through the roof this year! My wife has had 7 surgeries in the past year. She hit the insurance cap by July..I cringe when I hear the phrase "Medicare for all" you can still go bankrupt. Needless to say my stress level is in overdrive. Thank you for your input.
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From reading your reply, it sounds like you have a Medicare Advantage Plan. The only "advantage" to those plans is to the issuing company (Aetna, UHC, etc.). I never signed up for one despite the many mailings and phone calls to do so. I saw right thru their BS. Many doctors in my area are refusing to accept the Advantage plans for payment due to the rip-off policies and low rates they pay or refuse to pay. I have always wondered what will happen when these companies (Big Pharma, Health Insurers, etc.) suck out all the money from the common Joes like us and there is nothing left to get. Then what? They are going to go the same route as many companies before them have gone. They will price themselves right out of business. It is a damn shame that we, as the majority of people in this country, have to suffer because of the greed of a few. I can only hope that what goes around, comes around. Karma is a bitch. And it will come around to bite them in the behind. But at what cost of lives will it take to get there? Sad state of affairs in this country. Seems like everything in our lives is a SCAM! Designed to drain our wallets for the 1% of super rich greedy ones. Enough griping for me. It brings me down. I want to stay as positive as possible. For as long as possible. Getting harder every day. Take care and God Bless!They constantly bombard my parent with the calls, emails, and texts to join the advantage plan and it was overwhelming sometimes. She doesn't want to join one but they are being so aggressive it's getting harder and harder to say no. Fortunately we are still able to. It is unfortunate but we have a routine by now and I blocked several numbers. Scams are certainly prevalent, especially among the elderly, and it dies and up pulling in so many every year. You are not alone in disliking that! Keep on keepin' on, DPM
32 out 33 advanced industrialized countries have figured it out. We have the richest, brightest of the 33 countries. Its simple math! You don't want to pay a couple % more in taxes, but its somehow its cheaper to pay $12,000 or more in premiums plus deductibles and copays, and still get denied vital health care. If your employer didn't have to pay a fortune in premiums think about the raises you could get. I could go on. I guess my denial is going towards the CEO of Aetna's next yatch!
