Insurance Question

[bumdiddy.livejournal.com]

Hi I have a question I was hoping someone could help with. I usually get my nuvaring from planned parenthood but they have raised the price to $45 which is way too much for me so I was thinking of getting my prescription filled on my parents insurance instead. In general has anyone had any luck with getting the nuvaring for a decent price on insurance? And if I do that are my parents going to know about it? I have no idea how insurance works, like are they going to get something in the mail that says I have been getting the nuvaring? I know that probably no one can answer this for sure without knowing all the details about my insurance plan or whatever, but if anyone can answer in general I would really appreciate it. Thanks!

Comments

[voicesinherbody.livejournal.com]

I paid $30 for mine with BCBS.

All you do is provide your insurance information with your prescription at the pharmacy and you pay whatever copay your insurance has preset.

[kaceemorivan.livejournal.com]

I'm pretty certain they won't get anything in the mail for prescriptions (I never have, I only get things in the mail for doctor/ER visits)

However, you probably won't get the ring for a decent price with insurance. It's still relatively "new" in the world of medicine and because of that, the majority of insurances don't have it on their formulary or "preferred" list.

Basically, insurance companies have a list of all kinds of prescription drugs. The stuff on the list is what they'll be more than happy to pay part of, and in return you get a very low copay for.

There are lots of drugs NOT on this list. These are drugs they'll pay very little toward UNLESS you get your doctor to fight them and say that the non-list drug is the only one you can have and therefore, you deserve a price break.

I have very good insurance with Humana, but my ring was still 49.00 every month, so I stopped paying. All other types of BC don't agree with me, and even the ring was barely tolerable. I'm now not on any BC because of money and hormonal issues.

I would suggest going to the pharmacy, giving them the insurance info, and asking them to run the prescription. If you don't want to pay the price, they can always reverse the prescription.

[kaceemorivan.livejournal.com]

Let me clarify.

With my insurance, a generic is 10.00 and a brand name is 35.00

However, when a drug isn't on their list, it jumps higher than the brand name because they cover far less of the overall cost. So just because your insurance might have a 35.00 (or whatever amount) copay for a brand name, you might pay more because that brand might not be formulary.

[dial-zero.livejournal.com]

My mom, an RN, has called them "lifestyle" prescriptions. Things like Viagra, and yes, Nuvaring. It bugs me that those drugs are even in the same class. But until the patent expires on the Nuvaring and a generic comes out, it will probably remain on that list.

[nmbr5wthabulet.livejournal.com]

It varies from company to company. I have BCBSNC and it would be $35 for me.

[ktnzgtklws.livejournal.com]

It varies. I have BCBS PPO, and I still pay $45 for the NuvaRing. It's a new drug, so the companies don't want to pay any more than they have to for it.
Your parents shouldn't get anything in the mail. I never have, and I have several prescriptions. However, each company is different, so I don't know about yours. :-(
It would be worth your time to call several different pharmacies and ask what they charge, as well as calling your insurance provider and seeing what the coverage policy is in regards to the NuvaRing.

[pip3r.livejournal.com]

Nuvaring is $30, cheapest I've seen it and I've been on 4 different types of insurance on it.

[rachelish.livejournal.com]

I'm in this exact same situation. I love the ring and have been on it for two or three years, but I just can't afford $45 (I get mine from planned parenthood too.) I paid it last month, but I'm not sure what I'm going to do this month.

[bumdiddy.livejournal.com]

yeah it really sucks i used to get it for $20 from planned parenthood and then they raised the price to 30 for a couple months and now its 45, and i think all of their pills now cost 25 so i dont really want to bother switching if i can probably get the ring for 30ish on insurance. they should really make it cheaper i think a lot more people would use it if it was affordable

[rachelish.livejournal.com]

I'm just hoping there will be a generic at sometime in the future. That seems like the only way it would get a lot cheaper. I miss the days of the ring only costing $20. That was great.

[dayglow.livejournal.com]

At my college's health center you used to be able to get it for $12.50. No kidding. Then they passed that bill or whatever and pulled funding for college BC and it shot up to over $40. Just as I was planning to switch, too. :(

[drownophelia.livejournal.com]

mine's $40 a month from an Aetna PPO; just reduced from $45 for most of 2007. as it's a newer drug, and there are no generic alternatives, it will be expensive for a while. your insurance provider should have a list online, called a "formulary" which lists which medications they cover at what rate; or you can call the number on your (or your parents) health insurane card, and ask what the co-pay would be for nuvaring.

as long as you're not asking them to pay for a liver transplant, or something very expensive, i've generally found the customer service reps at my insurance company very helpful.

[bumdiddy.livejournal.com]

thanks for all the help. i think ill just go ahead and see what it costs on my insurance. hopefully a lot less than 45!

[beloveddoll.livejournal.com]

Also, something that folks didn't mention, is that in some cases, insurance companies won't pay for birth control for dependents. I had to fax letter after letter after letter and spend hours on the phone with my parents' insurance company in order to make them understand that I was prescribed BC for medical reasons (irregular periods, severe cramps, etc). Because they thought I was taking it "optionally", they refused to cover it.

Gooood luck!

[roseofjuly.livejournal.com]

Wow, I've never heard of that before...that's messed up...

[dying-in-stereo.livejournal.com]

your parents shouldnt get anything in the mail about your prescriptions. only doctors bills and the like. Ive been on many different insurance companies policies and Ive never been sent anything with a prescription list on it unless it was something i recieved during a hospital stay.

[kingofthekoopas.livejournal.com]

When I was on my parents' insurance, NuvaRing cost me $25/mo. Now I have my own insurance through my job, and the NuvaRing costs $48/mo. (I no longer use the NuvaRing, now I have a Paragard IUD.)

I'm not sure how your particular insurance provider does things, but here's how mine works. Every other month or so, my insurance sends me a packet in the mail showing me how much my insurance has covered, and what my co-pays have been for the year to date. So if I pick up a prescription with my insurance, the dollar amount in the "Prescriptions" column increases. The name of the medication doesn't appear on this paper. However, I can log in to my insurance provider's website and see a detailed description of what health care procedures and medications I've had this year.

[spiritualorchid.livejournal.com]

My parents' insurance only covers oral contraceptives, so I pay $57 for the ring.

Planned Parenthood.

[concreteutopia.livejournal.com]

I'm not sure what your situation is with your parents, if you are supported financially by them. But if you are not, planned parenthood will give you free birth control if you make less than, say $1200 a month. You have an option to change your annual income papers through them if need be, to keep your precious nuvaring. I know i can't afford mine!

Re: Planned Parenthood.

[whitelime.livejournal.com]

Different PPs have different policies and pricing. It depends on where the OP lives.

[arularia.livejournal.com]

Generally, whoever "owns" the insurance policy is going to get a statement which tells them about all the claims that have been made for a certain period of time. How specific that information is going to be probably varies a little bit. For example: My dad knows when I've been to the doctor, but he has no idea what kind of doctor or what I was seen for unless he calls me. (This lead to a few times over the years when I'd gone in for my annual pap and then later got a phone call from him going "oh my god, are you okay?! Why were you at the doctor?")

You may or may not be able to continuously refill your prescription with the insurance without jumping through some hoops that your parents are probably pretty sure to find out about. Some companies have what they call "maintenance drugs." Basically, those are anything you're going to be taking everyday for an extended amount of time like thyroid medication or, in your case, birth control. For those insurance companies, it can be cheaper for them to go through a mail order company instead which means you'd get a few months of medication mailed to your house at one time instead of picking it up at the pharmacy every month.

Generally, if your insurance does this, they'll give you a month or two in which you're allowed to pick it up at the pharmacy and they'll cover a portion of the cost, but after that initial period, if you don't do the mail order, they won't help with the cost and you'll have to do it full price.

[strand3d.livejournal.com]

If you REALLY can't afford your parents knowing you're on birth control don't use their insurance. Every insurance is different and in some states they will mail your parents into about what prescriptions have been picked up, etc. You could try other low-cost clinics and see how much they charge.

[strand3d.livejournal.com]

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[roseofjuly.livejournal.com]

On my parents' insurance plan, the NuvaRing started out at $15 a month for me. After a while, my dad's plan got even better and now all my prescriptions are free. (I am going to sorely miss my dad's health insurance when I graduate; good thing I'm going to graduate school). But it all depends on your parents' specific plan. Some people pay more, and some pay less.

As far as them knowing, I don't think so. I just got an abortion on my father's insurance and he's none the wiser, although it was just last week. And I've been on birth control for years on my father's insurance, and he didn't know what it was until he actually saw the BC on the kitchen table one time. I think that if your father/parents check their insurance statement, they can indeed see it -- the hospital/pharmacy is required to release any information to the payor about things that they've paid for through their insurance.