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Author Topic: prescription drug coverage on dialysis  (Read 2068 times)
Lillupie
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« on: June 25, 2012, 01:25:24 PM »

Sooo,
 I have medicare and now Tricare (through my husband's military insurance)

I go through Davita. They said that the medicine that is through bundling has to go through Davita pharmacy. I really hate getting prescriptions delivered to my home. Another thing is I have a dermatological prescription that is a compound, well a mixture, and Davita pharmacy told me I would have to get the compound somewhere else because they dont do compounds.

So, since I do not have Medicad anymore for prescriptions, do you know if I can take all of my prescriptions to a local pharmacy so I can have them all done at one time?

Thanks,
Lisa
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It is my utmost dream and desire to reach out to other kidney patients for them to know that they are not alone in this, also to reach out to those who one day have to go on dialysis though my book i am writing!

dx with lupus nephritis 5/99'
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amanda100wilson
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« Reply #1 on: June 25, 2012, 01:53:53 PM »

No, the bundled  items go through Medicare and are billed by Davita directly to them.  This includes epo, iron injections, hectorol (not sure if there are any more items that are).  They have nothing to do with Medicaid.  Your compound item will not be included in the bundle, so this you can get filled at your local pharmacy as long as it is one that does compounds (not all pharmacies do).
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ESRD 22 years
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  -Transplant 10 years
  -PD for 8 years
  -NxStage since October 2011
Healthy people may look upon me as weak because of my illness, but my illness has given me strength that they can't begin to imagine.

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smcd23
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« Reply #2 on: June 25, 2012, 03:19:07 PM »

You should be able to fill all non dialysis related meds through your local pharmacy, using Tricare or whatever prescription drug coverage you have.
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Caregiver to Husband with ESRD.

1995 - Diagnosed with vesicoureteral reflux and had surgery to repair at age 11. Post surgery left side still had Stage I VUR, right side was okay. Both sides were underdeveloped.
2005 - Discovered renal function was declining, causing HBP. Regular monitoring began.

March 2008 - Started transplant evaluation for preemptive transplant due to declining function.

September 16, 2008 - Transplanted with my kidney.
September 18, 2008 - Kidney was removed due to thrombosis in the vessels in and leading to the kidney.

October 2008 - Listed in Region I

May 2009 - Started in Center Hemo
January 2010 - Started CCPD on Liberty Cycler

June 15, 2012 - Kidney transplant from a 43 year old deceased donor
June 22, 2012 - Major acute rejection episode and hospitalization began
June 27, 2012 - Nephrectomy to remove kidney after complete HLA antibody rejection. Possibly not eligible for another transplant, ever again.

Now what?
cattlekid
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« Reply #3 on: June 25, 2012, 04:24:57 PM »

DaVita will try to get you to use their pharmacy.  I have private insurance (Caremark) and am not on Medicare yet.  I told them from the get-go that I do not want or nor will I be allowed to use the DaVita pharmacy for anything.  But they went through all the time and effort of asking Caremark if they could get permission to bill them for my meds and they got a big fat NO from Caremark, which makes sense since they own CVS!  So the only thing I get through DaVita is the EPO.  Everything else, I continue to have to pick up at my local CVS or get through mail order if I feel like it. 

Just another example of the conglomerate DaVita is trying to become....I shudder to think that they are looking at forming a renal ACO.  I do NOT want all of my medical care coordinated through DaVita....you just know that they will do everything in their power to keep you on dialysis forever in their cookie-cutter ways and god forbid you don't toe the party line!
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KAF454
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« Reply #4 on: June 25, 2012, 05:57:22 PM »

Davita tried everything to get me to use their pharmacy but all I get from them is my epo. Medicare A&B is my secondary insurer and doesn't cover pharmacy any way so everything but epo goes on my FEHBP and gets filled at my local pharmacy. I like having a local pharmacy handling all of my prescriptions - regardless of who writes them. It's a lot safer from the standpoint of catching potential negative interactions. And the local pharmacy gives me a nickel a gallon gasoline discount per prescription filled. I told Davita about the gasoline discount and they gave up.
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Today I will not worry unless the animals start lining up 2 by 2.
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