I just discovered that on top of the 11% premium increase - my current provider is not going to cover Tacrolimus or Prograf. Frankly, they will but at a higher price than I could buy it without them. I'd like to spell out the facts:
For the two of us (my wife is relatively healthy) ....
* Combined went the to visit a doctor ~ 6 times last year (of those, 2 were dermatologist, semi-unrelated to my kidney transplant)
* Combined lab work ~ 7 times.
* Kidney Meds (lots) and a few ancilary for her.
* I personally have not seen a DOCTOR for years - only the nurse assistant and she ignores most of what I ask and seldom returns calls with questions.
* We are both self-employed (Aka ACA / Obamacare, call it what you want).
* Paid ~ $15,500 (Premiums) + Various Co-Pays & Montly Bills ~ 1,100 + Rx Co-pays ~ $525 = ~ $17,125 (both of us).
I am seriously dropping it and paying (seldom) as I go. I know most of you will jump on me and say how you'd never do such a thing. I respect that but please don't say it. I know that and that is why I am posting here - looking for some alternative / odd-ball means that someone lese might be able to offer as a solution. The good news is that the others Rx (meds) are still covered for now. The irony is that this is Oscar Health, co-owned by the Cleveland Clinic Foundation (CCF) forcing me to consider something drastic of going without and hoping for the best. A bad strategy, but it's so much moeny for less and less.
Has anyone had luck with online presciption? If so, how do you get a doc script? Most doc's (I've heard) refrain from writing a script to an online pharmacy (US or Asian).
IF I were to drop it, does anyone have experience with some sort of telemed (to get a Rx or normal review)?
I possibly might dumb down the coverages (Gold >> Bronze) but all of the math adds back to roughly the same place. It's a shell game.
For the record, I / we can afford this. It hurts. Fact is we pay a tremendous amount AND it's at a point of removing the vital coverages for it to be worthwhile. I would roughly estimate the increase (premium and self-pay of Tacrolimus) to be an additional of ~ $3,000 from above. This assumes the CCF would actually do something like write a script to an online pharmacy (I doubt it).