What meds aren't covered by insurance?

[Roadrunner]

My out of pocket expenses are going up with each new prescription.

When my husband got iron in center it was paid by medicare but now that he is on home hemo we have to buy iron pills.  Ferrix was costing about $20 per month but now the doctor is doubling his dose.

Renal caps are a vitamin and so are not covered by insurance

The doctor just switched him from hectorol which was covered to Calcitriol which is not covered and costs  $65.38 for 40 pills with the AAA discount

Phoslo cost almost $20 for 180 capsules.  He takes 5 or 6 a day so this is just a months+ supply

I'm not even including this other medicines for his heart and diabetes.

Is this unusual?  Are there substitutes that are covered? 

[thegrammalady]

i'm on medicare and so far they have covered everything i take and the renegel and sensipar are over $500 each!

[flip]

I have Medicare plus private insurance and I never pay over $10 per script. Many drug companies will furnish drugs if you qualify.

www.pparx.com

Hope this helps.

[Tío Riñon]

I searched the archives for any current information and didn't find anything, so I'm going to ask...

Any tips or suggestions for Renal Vitamins?  Since insurance won't pay for them and I'm not interested in paying $50+/month, I need some options.  Can you appeal the policy due to kidney disease or are there OTC alternatives?

[cattlekid]

A couple of suggestions:

1.  With the iron, why can't he still get it in center when he goes in for his monthly meetings with the nurse?  That's how we did it when I was on home hemo.  Once a month, I had to go in and pick up supplies and go over lab results with the nurse and that's when I got my iron infusion if I needed it.

2.  With the Renal caps, do you have a doctor's prescription?  If not, I would get a doctor's prescription so they can run it through the pharmacy.  I got my renal caps through the pharmacy for my regular co-pay as well as my phoslo.  With phoslo, my doctor wrote a prescription for the maximum amount (9 pills a day) but I only took six, along with three Renvela.  So I would get a 90 day supply of phoslo, 810 pills for one $10 copay.  Then for the Renvela,  it was still brand name so I would have had to pay an arm and a leg.  I went to renassist.com and got their discount card.  With the discount card, I only had to pay a fraction of what I would have had to pay in co-pay.  This discount card only works if you do not have prescription coverage or if you have private insurance, it does not work with Medicare Part D.

Hope this helps a little to at least start a discussion with your doctor and center....

[amanda100wilson]

I have never been able to get renal vitamins paid for even with a doctor's prescription.

[Dman73]

I take Dialyvite 800/Ultra D once a day and have been on it for a couple of years.
The price is reasonable at 15.95 for 90 day supply and also has a volume discount.
They have 6 different formula's to suit your specific needs.

http://www.dialyvite.net/

[jeannea]

I thought my insurance was not covering Renocaps (my vitamins) but the pharmacy charged around $11/month. Can you check other pharmacies? Or talk to your doc and make sure he's prescribing the cheaper drug and not the most expensive newest brand name?