Questions about insurance coverage–BC/BS

[PhilC]

Hi Diana,

Based on your experience with doxycycline, a switch to Minocin makes sense. However, if your doctor ever wants to switch you back to doxy for any reason, I would request that he or she prescribe Doryx (as long as the doctor has no reasonable objections, of course). Doryx is doxycycline hyclate in a delayed-release tablet form, which you may be able to tolerate better. There are no generic equivalents to Doryx.

See:
http://www.wcrx.com/products/doryx/

Another possibility is to try doxycycline monohydrate. It is supposed to be less irritating to the GI tract. I recently switched to Watson generic doxycycline hyclate which seems okay. I often have some low-level discomfort in my lower abdomen, though, and I suspect that the doxy is responsible. I've been contemplating a switch to doxycycline monohydrate to see if that helps.

Phil

"Unthinking respect for authority is the greatest enemy of truth."
- Albert Einstein

[mystic1949]

Thanks Phil

    I didn't realize there were variations within the doxycycline genre.  I take doxycycline hyclate/Watson.  Both of my grown sons have mycoplasma infections, one has RA.  One took mynocycline for 18 months with no positive impact on his two strains of myco.  The other one tried mino for about 6 months and saw no improvement.  I took the doxy for about 8 months and finally felt too lousy to continue, although I felt it was having some effect on my joint pain and inflammation. So I figured I would switch to Minocin and go for the big guns right away.  My Dr. put no substitutes on the script but it didn't seem to matter.  My sons have found doxy to be hard on them as well.  I might just buy from Canada and get it for all three of us.

I heard that Lederle Pharmaceuticals makes Minocin,  and that if, by the luck of the draw, you can get Lederle generic minocycline, this is the same med…any truth to that?  My son tried Walmart which often carries the Lederle generic minocycline…but it was not the Lederle brand.  So he took the generic they offered him, and it didn't do much for him. 

Diana

[PhilC]

Hi Diana,

That information about Lederle is outdated. I read that Lederle generic minocycline hasn't been available since around 2001.

When I switch to minocycline later this year I am going to try the generic minocycline tablets made by Par Pharmaceutical. My reasoning for choosing that particular generic is explained on this page:

http://www.rbfbb.org/view_topic.php?id=2581&forum_id=1

Do you have a BC/BS card? If so, the co-pays for prescription drugs should be listed. At least they are on mine. On mine the co-pay for generics is $10 and $50 for brand-name drugs. So I should be able to get a one-month supply (60 capsules) of Minocin for $50. Assuming the doctor were to write the Rx correctly, of course.

Phil

"Unthinking respect for authority is the greatest enemy of truth."
- Albert Einstein

[mystic1949]

I'm going to look into all of this.  thank you for the link.

We have Federal Employee Plan bc/bs….had the same plan for over 30 years. Not the basic but the better plan.  I don't have a prescription card, no.  We never got one. Our co-pays are quite a bit higher this year and they do say something about $50. for name brand in the yearly book we get, but we have paid more than that for other things. I am going to read it more thoroughly. They deny any compounded stuff we get, and yet our compounded prices on hormones, etc. are WAY less than the co-pay on something like Androgel for my husband and the doses are far smaller.  The copay just last month for testosterone pellets from a compounder was $272.  but bc will pay for “installation”.  I don't even bother trying to submit some things any more…they deny things like saliva testing and over 1200 worth of Great Smokies tests I submitted a few years back. I am fed up with them really. I'm glad my present doctor is on the PPO list and able to bill things so that they pretty much pay for them…in the past, other holistic doctors would want the money up front and bc/bs rarely paid even 1/10 of what I paid out. 

Don't get me started…our house was nearly paid off and we remortgaged it for $225,000. in order to pay off all the credit cards used only for my health care and meds, supplements, etc.:blush:

Diana

[PhilC]

Diana,

I was not referring to a prescription card. I was talking about a little ID card that I get in the mail every year that has my BC/BS subscriber number, group number, etc. on it. It also lists the co-pays for different things.

I think you should look into this a little more and find out why you were asked to pay more than $50 for your Minocin Rx. Either the doctor messed up and didn't write the prescription correctly, or the pharmacy messed up. Those are two possibilities to investigate and try to rule out. Also, perhaps you are required to pay your prescriptions in full and then file for a refund with BC/BS? In the past I had to do that and it was a pain. But I haven't had to do that in a long time because they changed it around ten years ago.

By the way, my prescription drug benefits are handled by Medco, and BC/BS encourages us (on their web site) to have our prescriptions filled (via mail order) through Medco. I haven't done it because the supposed savings don't exist; I think the only reason BC/BS pushes it is because it saves them money. However, that may not be the case for you.

I just found this web page:

http://www.fepblue.org/pharmacy/

I don't know if that web site applies to you, but if it does then the information on that page may be helpful.

Phil

"Unthinking respect for authority is the greatest enemy of truth."
- Albert Einstein

[mystic1949]

We haven't gotten a new card since 1985!  And we need to tell the Dr.'s office what our co-pays are on the office visits, because there is nothing written on the card. We haven't had to pay and file for them in several years now…but recently, we paid over $50. for my husband's Plavix and that does not come in generic yet, from what I understand.  anyway..I will check into it.  It was fine for all the years we never filed a claim…now, it seems we have to watch them every second.

Diana

[PhilC]

Hi Diana,

Call BC/BS and ask them to send you a new card. And check to make sure that they have your correct mailing address. Have you moved since 1985? If so, perhaps they've been sending mail to an old address?

As for the prescription for Plavix, I would file a claim for that. You will probably be reimbursed for the amount over $50 that you paid. If not, and they reject the claim, they should say why.  And if they don't, you'll be able to press them for a reason why they rejected it.

Another idea is to try a different pharmacy. That might help determine whether the pharmacy you have been using is at fault.

Phil

"Unthinking respect for authority is the greatest enemy of truth."
- Albert Einstein

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