Community Forum Archive

The Epilepsy Community Forums are closed, and the information is archived. The content in this section may not be current or apply to all situations. In addition, forum questions and responses include information and content that has been generated by epilepsy community members. This content is not moderated. The information on these pages should not be substituted for medical advice from a healthcare provider. Experiences with epilepsy can vary greatly on an individual basis. Please contact your doctor or medical team if you have any questions about your situation. For more information, learn about epilepsy or visit our resources section.

Cost of my medications. I am nearing 65 and eligible for Medicare.

Sun, 01/03/2016 - 18:03

Topic: Insurance Issues

I have been taking Lamictal (100mg) and Vimpat (50mg) to control my seizures. My present insurance company is Blue Cross / Blue Shield. With BC/BS I am paying approx. $150.00 per month for Lamictal and $50.00 per month for Vimpat. I take 4 pills per day of Lamictal and 3 pils per day of Vimpat. I am retired and I am struggling to pay for the meds. After a great deal of testing my Neuro found that this combination has been successful at controlling my seizures. My Neuro has also determined that the generic Lamictal (Lamotrigine) will not work for me. Very shortly I will go on Medicare and get a Plan D - drug coverage. My research revealed that there are no Part D providers that will cover Lamicatal and Vimpat for an affordable price. My Neuro has attempted to work with the Plan D providers to get both of my drugs on their formulary without success! The providers suggested I try "step therapy" as a way of reducing the cost of my meds. I want to avoid this process as in the last 25 years I have tried most of the anti-epileptic meds and it has been proven (at least to me and my Neuro) that the present meds work the best.

Question: Can anyone tell me how I can reduce the cost of my meds without resorting to step therapy?

Question: Is it possible to get assistance from the drug manufacturer or some company / agency? (Note that I am not on disability.

Please help.

Comments

Try checking with Well Care I

Submitted by just_joe on Fri, 2016-05-13 - 15:56

Try checking with Well Care I take Vimpat 2 a day and a months supply is 7 bucks and some change. They are also working on providing a additional plan but before you add it do tell them who your doctors are or the hospitals they are associated with

Sometimes it's about finding

Submitted by RacerX35 on Fri, 2018-06-15 - 16:07

Sometimes it's about finding the right insurance broker, and that can be hard trying to find others that can get in on that. I have a a plan set up for me with a lot of other people through Blueshield of California. I make my co-pay up to $2,000 a year and then Blue Shield pays 100% after. I recently had an issue with my insurance on covering my Lamictal due to cost after I reached my max co-pay, due to hospital stays and more testing getting ready for more surgeries. Come to find out that each bottle of Brand name Lamictal costs around $3,000. I am taking 4 tablets a day which ends up totaling about 4 bottles and $12,000 a month. I can see why my insurance doesn't want to pay that. All of my neuros want me taking name brand only, so they have to pay for it. Just for my hospital stays and testing my insurance has had to pay over $50,000 and we are only up to the first half of the year. So hopefully you can get some advice to going in the right direction and the best coverage for you prescriptions. Good luck to you.Later,Racer

Sign Up for Emails

Stay up to date with the latest epilepsy news, stories from the community, and more.