Heads Up For Folks Getting Prep From Kaiser California. Price Increase.

[rawfuckr]

Kaiser has bumped Truvada to the specialty tier for the 2015 individual plans so expect to pay at checkout a lot more than before. Will usually be 10% or 20% depending on your plan. That's either $130/month or $260/month.. Good thing is that Gilead will reimburse you but you will have to go through the trouble of submitting the paperwork. I don't think this applies to group plans, only individually purchased plans and those plans obtained through Covered California.

 

Letting people know.

[seaguy]

Insurance companies are such fucking blood suckers.  Pharmaceutical companies are just as bad.

[rawfuckr]

Insurance companies are such fucking blood suckers.  Pharmaceutical companies are just as bad.

 

The thing that irked me the most after checking out the formulary was the fact that ALL HIV meds had been bumped up to Tier 3 - specialty. Things like complera, stribild.. If you are neg you sort of have an option not to do PrEP, but you if you are poz you have have to suck it up. I'm thinking Kaiser is aware of the copayment programs and that people can still get their meds free if they work at it, but for them this is obviously cheaper.

 

By the way, bumping HIV medicine to a higher tier is a clear case of discrimination due to pre-existing conditions that the ACA did away with.. only on the monthly premium front. The insurance companies quickly found a way to continue charging more for the sick even being complaint with the ACA.

[wood]

The thing that irked me the most after checking out the formulary was the fact that ALL HIV meds had been bumped up to Tier 3 - specialty. Things like complera, stribild.. If you are neg you sort of have an option not to do PrEP, but you if you are poz you have have to suck it up. I'm thinking Kaiser is aware of the copayment programs and that people can still get their meds free if they work at it, but for them this is obviously cheaper.

 

By the way, bumping HIV medicine to a higher tier is a clear case of discrimination due to pre-existing conditions that the ACA did away with.. only on the monthly premium front. The insurance companies quickly found a way to continue charging more for the sick even being complaint with the ACA.

 

 

Yup.

 

I like *some* of what the ACA did, and its a good start, but it still doesn't address many of the root issues why costs are spiraling out of control.  Drug costs are one thing, as are basic care items.  Someone is still paying huge costs for somewhat basic care and meds, and that's why insurance rates will still rise. 

[discreetmpls]

See if your doctor has the Gilead co-pay cards.  It was as simple as calling an 800 number and giving some basic information, then giving the card number to my pharmacist.  No paperwork, no waiting, and they will pay up to $200/month of whatever copay you are responsible for.  Basically the paperwork is done by the doctor's office and they get a stack of them to give out.

[rawfuckr]

See if your doctor has the Gilead co-pay cards.  It was as simple as calling an 800 number and giving some basic information, then giving the card number to my pharmacist.  No paperwork, no waiting, and they will pay up to $200/month of whatever copay you are responsible for.  Basically the paperwork is done by the doctor's office and they get a stack of them to give out.

 

You can get into the copay assistance program yourself, it's very very easy going to this website http://www.gileadcopay.com/

 

They've upped what they will pay, now it's up to $300/month which is great

 

The problem with Kaiser is that you have to use their pharmacies, and their pharmacies will not honor any sort of copay coupons. Therefore you have to initially pay the copay yourself. Gilead knows this, so they have a form you can ask for, and you fill it out with your RX number and other things, mail it, wait a few weeks and then you get a check in the mail. Cumbersome, but much better than nothing.