BCBS Double Copay On Thyroid Meds

Mary is freaking out because BCBS of Maryland just doubled the copay on her thyroid meds. Times are tight, and Mary doesn’t have a thyroid. The insurance companies have been telling her for years that Consumer Reports Best Buy Drugs is a generic, now BCBS has classified it as not being generic. She’s pretty ticked, and considering getting married to her fiance early just to get on his insurance. Her letter, and how she might save $200.32 a year, inside.

My thyroid medication, having been around for 40+ years, has been considered a generic for years by every insurance company I’ve had in the the past five years (same employer, but the plans keep changing). The costs for my usual three-month prescription have been going up, from 15$ 5 years ago up to 30$ for the past couple of years. So I was a little surprised that yesterday BlueCrossBlueShield of Maryland would only pay $14.92 on a $75 total for my usual 3-month prescription, leaving me to pay $60.08 as a co-pay.

Now an extra 30$ extra every three months won’t make me broke, but I do wonder why I’m paying 120$/month for insurance that is basically useless to me. I called BlueCross and their response was that my prescription isn’t considered a generic anymore but a “nonpreferred Tier 3 medication” (whatever that means) with a copay of $100. Since the total cost of my prescription is $75, they “pay” a pro-rated percentage. When I asked about my limited options were since I’m already taking a “generic”, their response (and this is a quote) was “we can change our copays at any time”.

I can’t be the only one in this situation, since thyroid hormones are among the most prescribed medications in the country. Since I don’t have a thyroid, not taking medication isn’t an option for me.

I also wrote to my employer: it’s a small company, so BCBS is the only option we have for insurance. We all just renewed our insurance on 5/1/2008, and the paperwork we were all given in April to mull over said my prescription would remain @$30 for a a three-month supply.

I do have an out as far as changing insurance companies, since I’m getting married and my future husband can add me to his insurance. The wedding isn’t until next year, however, so we may have to go to the courthouse in the very near future – like next week – so I can get better health insurance.

First, the bad news. Along with Synthroid, Levoxyl is actually brand name (source: Drugs.com, Medicine.net). I don’t know whether the insurers in the past mistakenly said it was a generic or what, but it looks like BCBS is right.

Now, the good news. The generic for Levoxyl is levothyroxine, and Target will sell you a 3-month supply for $10. So will Wa-Mart.

Even if you’re paying for this out of pocket, it’s cheaper than your copay was even 5 years ago. Hope this saves you some money, and a trip to the courthouse. Of course, consult your doctor first before switching out any medication (especially as some commenters are saying generics can actually vary subtly from the brand name, and some patients can have adverse reactions to different kinds of thyroid meds). Here’s another potentially useful idea from commenter Bohemian:

“Some people can’t take the generic versions of the brand name thyroid medications. They do actually have a different formula to them so some people are unable to properly absorb the generic drug.

She could try disputing the BCBS change. Most BCBS plans still consider synthroid to be a lower tier medication so the copay is cheap. Sometimes a doctor’s note stating that the patient can not take the generic alternative is enough to get an exception to the increase thus putting the drug back to the lower tier pricing.”

(Photo: trekkyandy)

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