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Good 'Ol Aetna. At it again.

So my insurance at work is very good in most. respects.  Company pays a large part of the total cost.  Very pleased to have a good job and insurance.  But why does Aetna have to make everything so hard?

Starting with the sirolimus I just received, they'll only ship a 1-month supply.  The next batch is shipped 1-week before you need it to stay alive!    I kind of like having a few weeks or even a month extra, just in case there is a problem.  Ya know?  Ever heard of hurricanes?  Ever heard of UPS / Fed-x loosing a package?  Ever heard human error?  Ever had a package be delivered to the wrong place?

I'd pay an extra 5% just to go back to BCBS. 

Anybody else lucky enough to have Aetba insurance?  

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  • I use to get my tacrolimus from Aetna mail order pharmacy until someone at Aetna decided they would make more money if they called it a speciality drug. The cost to me went up 4 times the amount I paid through mail order. I was also worried that I would run out in the event something happened to my shipment. I was taking 1mg twice a day so my coordinator sent in the prescription as 2 1mg pills twice a day so I had some just in case.
  • Hey guys,
    Wow, this is interesting. This was my first year signing up with an advantage insurance program. After a trip to my senior citizen center and weeks of research I was still unsure. I first had to find out if I was ESRD, something the senior center ask and I was not sure. I know you guys already know after txt we are not. So I could proceed. In NC we have three choices, Humana, Aetna, and First Medicare Direct, no BCBS in my zip code. To make a long story short, after weeks on the phone getting different answers, I talked with a very nice person at the senior center who walked me through how to look up plans on the computer at like they are trained. Man, wished I had know this to start with! Anyway, this made it much easier and nicer not to depend on some stranger on the phone. So with drugs being the biggest concern, Aetna was the lowest by hundreds even in the Gap. I guess I will find out about mail order this year and all the other unknowns. What else are we to do? My two drugs sirolimus and myfortic retail $17,000 a year. What did everyone else find out and who did you guys sign up with? I do know we have until Feb. 14, 2018 to change. Thanks guys!
  • hey Steve ,  guess I am late to the party here ....  I am premantly disabled atm ..   and I was able to get on medicare  ,  being on medicare prior to txplnt ..  medicare covers rejection meds 100 %  I to  use Aetna but my 2 other meds I get  localy  here at home town  pharmacy ...  my rejection meds  I get from Amber pharmacy which is in Nebraska..    I live in Central NY .  post 7 1/2 years  and never have had an issue recciving meds from Amber  at 30 days at a time  ... not sure how Aetna  works with them  but if you decide to go mail order  see if your txpnt team  coordinator can call and get you any  info  from them ,  message me  if you want their toll free phone number ...

  • Steve, I didn't have to buy the meds.  In the couple of years following my transplant, my insurance carrier changed three times, through changes in employment.  Every time there's a health insurance carrier change, the patient has to obtain a new prescription for their meds.  Even though I didn't need the meds, I filled the prescriptions anyway, hence my three-month supply.  :)

  • I have United it it's the same story - one month at a time, it's costly for the insurance company to pay for these meds, however CVS/AvMed was totally different, could order 3 months at a time, no problem.  It's the insurance company's policy and yes I like to have Xtra too!  and I do, about 3 months worth!!

    • So, I guess you bought the meds on your own dime?  That's my plan, to get my docs to write a scipt for a 1 month supply I can buy locally.  It'll cost $$, but I want that extra just in case.  Not sure they will, but I'm hoping they will.

      I've written Aetna and companies HR VP expressing my concern.  They're "looking into it".  I have documentation so that if for ANY reason I run out of meds and reject my lawyers can win for my widow.  Isn't is horrible to have to even think about that?  Why are they like they are?  I think most juries will sympathize enough to make them wish they'd ponied up a few extra pills that I was going to take anyway.  

  • I hear you loud and clear.  I spent most of my career making sure insurance companies paid what was due to hospitals and clinics for their services. In the last five years I had a hit list of insurances that made things difficult, almost to the point of impossible.  Aetna was was of those on the list.  I have no suggestions for better service.

    I was skeptical last year when Aetna showed up as the best fit for my wife's Medicare Part D plan.  There's was a few hundred lower than any others.  They have performed well, but my wife's meds are generic.  She just now met her deductible.  They just negotiated a better price than the others.

    I can't agree more about wanting (actually needing) a month extra supply.  There are too many things that can impact prompt delivery.

  • Hi Steve,

    Have you tried Aetna's mail order home delivery program?  (90 day supplies with 3 refills available) may make life more bearable.  I do not know if sirolimus is part of it, but it is worth asking/signing up.  Now that CVS has bought out Aetna, changes may be coming.

    Aetna home delivery

    Aetna Exclusions Policy

    Rx Home Delivery | Aetna
    With Aetna RX Home Delivery,<span class="superscript">®</span>you can get maintenance drugs sent directly to your home.
    • Anti-rejection meds are "Specialty Meds" and have to ship from "Aetna Specialty Pharmacy".  Regular Aetna home delivery is a different deal for me.  But thanks for suggesting it.  

      Rx Home Delivery | Aetna
      With Aetna RX Home Delivery,<span class="superscript">®</span>you can get maintenance drugs sent directly to your home.
  • I have Blue Cross Blue Shield and its not any better. They require me to mail order my tacrolimus and myfortic and only do one month supplies. The company that does the mail order is Express Scripts and they are so unreliable it is ridiculous. I will start trying to call and place my order a week before I run out and inevitable something will go wrong. They will only ship the package with a signature required since we live in an apartment complex but my husband and I both work full time 8am-5pm and are never home to sign. So the medication gets routed to the UPS warehouse downtown where I am not able to pick it up til the next day after work. And have to drive 30 minutes each way to a sketchy part of the city. It is so frustrating! It also makes me nervous. If everything goes perfectly, the turnaround time is 5 days!! But of course as you point out there is human error, lost orders, now we are coming up on Christmas and UPS will be very busy, plus snow is coming...

    I would definitely pay more just to be able to pick my meds up from Walgreens. I have to mail order those two and then pick up the prednisone and lisinopril from Wagreens and now they are on different schedules. The good news I guess is I only pay $10 each for the myfortic and tacrolimus but honestly I would pay more for the convenience of just using Walgreens. Sigh.

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