Submitted by mandapanda2891 t3_10dilxk in massachusetts

Hi all! I recently filled a few prescriptions, and one of them essentially doubled. I have BlueCross, has anyone else had this issue as of the first of the year, that you were able to find an answer for why? It's for the generic of Adderall 20mg XR, and BlueCross has been basically unable to give me any answers. Thanks!

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IntelligentMeal40 t1_j4lm40x wrote

How much more is it? Back when I had to purchase Adderall with cash because I didn’t have insurance AAA made the $90 prescription only $30 at chain pharmacies. CVS told me a lady got her $900 dog medication down to $90 with AAA.

I have Medicare so mine is only $3.50.

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mandapanda2891 OP t1_j4lmoaf wrote

It went from just under $30 to just under $60, the regular release I'm on as well increased slightly (around $1), which is why this is making no sense to me. I did find coupons but in MA you can't use them instead of insurance

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BU0989 t1_j4lo3xi wrote

I’ve been waiting for that very same RX since December 26! Every CVS I’ve called has been out of stock. I’m wondering if I’ll run into the same issue since I also have blue cross

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mandapanda2891 OP t1_j4lodlk wrote

Idk where in MA you are, but I typically don’t have any problems filling the XR at Walgreens on S Broadway in Lawrence! the regular release had been a pain up until recently though. 🙄

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Beck316 t1_j4ls6nc wrote

I wonder if the Adderall shortage had anything to do with it. It's not uncommon for prices or copays to change with new plans, new year etc. It could be something negotiated by your employer for the plan for the upcoming year, if your insurance is employer based.

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mandapanda2891 OP t1_j4lt37o wrote

So I didn’t put it in there, but I actually work in insurance! My plan is through my employer, and nothing on the plan itself had changed. They didn’t change the tier of the medication or anything. Basically the only thing that changed was the pharmacy benefit manager went from ExpressScripts to CVS Caremark, they also told me their “formulary changed” but they could not (or would not) give me any more information than that. The shortage would make sense, but it’s not the regular one that increased it was the XR, so I’m like totally lost lol.

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mandapanda2891 OP t1_j4lt8c2 wrote

Definitely! I would call around to see if any other pharmacies have it, you would likely just need to have a brand new script written and sent over by your Dr which could also require a new authorization from insurance

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leeann0923 t1_j4lur4q wrote

Do you have a prescription plan deductible? Sometimes certain meds will fall into new buckets where they are covered but require a deductible to met before they receive more coverage.

They also reset any price negotiations or preferred meds at the beginning of the calendar year. I’ve had patients with the same insurance and the same med for years and come January, the coverage is different (often less, rarely more), or in some cases, not covered at all moving forward.

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Snufflarious t1_j4lwq47 wrote

Tufts here - $250 deductible kicks in after new year

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Vsercit-2020-awake t1_j4m3etz wrote

Yeah having the same issue. Called around and everyone said that the whole area is out. Think this is a blue cross thing or supplier thing? I had to get a new rx for 10mg tabs to get the dosage that way but had to lay like 3x the price.

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mandapanda2891 OP t1_j4meh2e wrote

I think it’s a supply thing as far as pharmacies not having them, it’s been like that since September/October for the regular release adderall. For the price though thats a Blue Cross thing, but no one can tell me why the price increased for me.

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JasnahKolin t1_j4meklr wrote

I know this one! A few years ago they moved several XR dosages to a higher price tier as a "non essential" form, for Tufts Health insurance. My Rx went from 12? bucks to 75! Now I take regular Adderall every 4 hours instead. No shortages, inexpensive. The only downside is if you forget to take it.

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mandapanda2891 OP t1_j4mey1r wrote

So that’s the weird thing! I have blue cross and the tier didn’t change, but I am considering asking my Dr if I can take more of the regular ones, and forgo the 20 altogether once the shortage is straightened out cause that would be cheaper for me as well.

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melanarchy t1_j4mi7uz wrote

If this is the first time you've refilled it in the new year it's possible that your insurance coverage changed slightly with regard to prescriptions.

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PakkyT t1_j4mshqi wrote

Check with the pharmacy if you were issued generic versions where previously you got the brand name. I recently had this happen to me where there is a law now that that says substitutions of a alternate (generic) version of a drug is required if available. CVS claimed they had to use the generic in all cases where as looking into it more MA .gov pages would imply that is true only if the generic is cheaper (Source). In my case, a dry power inhaler went from $30 for the brand name to something like $64 for the generic. I was able to get them to try and get the brand name back at the original price and they were able to.

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mandapanda2891 OP t1_j4nq31y wrote

I appreciate this! I have been on the generic this whole time, but I may ask them to price the brand name with my next fill, cause when I did it myself on their site (which who knows if it’s even accurate) it was actually cheaper for the brand name than it was for the generic.

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melanarchy t1_j4o4gts wrote

FWIW I'm in bcbs too and we got word that they'd put the old (and now incorrect) rx info on our new cards and were sending us cards with the updated correct info, but that's likely very dependent on where you get your insurance from (work or marketplace or whatever).

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pixieanddixie t1_j4pky8s wrote

Hi! I get my all of my scripts filled at stop and shop. I use GoodRX and sometimes that makes it less expensive than the insurance copay.

If you look on GoodRX, you can type in your prescription and see the prices of all of the pharmacies near you. CVS is almost always obscenely expensive for everything.

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mandapanda2891 OP t1_j4q2psx wrote

I got new cards with the new rx info, but according to BCBS the new rx info didn’t affect the actual cost or anything, it’s just because it’s through a new pharmacy benefits manager, that’s what’s making all this so confusing, like as to why it just about doubled in cost

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pixieanddixie t1_j4q5eiu wrote

Hmm you should still use good rx to look up the different pricing.

I definitely use good rx for my controlled substance prescription (Ritalin) at stop and shop and it’s like $12 for a one month supply.

Good luck!

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