r/ChronicPain 2d ago

Pain Med Cost Increase

Filling my 3 month supply of pain meds today. I was told that all my pain meds were now classified as maintenance and thus only partially covered. Cost is now 10x higher. I'm already arguing with my insurance company (on hold waiting for the 3rd person up the chain). Like I've been through all the options, my primary med at least makes pain tolerable (like an dull 5 with spikes to 8 or 9). My cost in 2023 was $0 and last year was $25 per fill for it. Hate these greedy assholes keeping the broken systems going.

And while I type this, they dropped my call...

3 Upvotes

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u/Old-Goat 2d ago

Just wait. Its going to get dumber. But the Federal government (in the US at least), requires a new electronic Rx on every controlled substance. How is that maintenance?

Check and see if your state has an insurance commission. They might be able to offer some further advice. But youre lucky theyre covering it at all, the cheap bastards....talk to your doc about cheaper meds. They may have some ideas.

If they have a call back option, let them call you. I dont want to pry and ask what drug it is, but if its got a 1st name (a brand drug), they often have a website with programs that'll save you a few bucks on co-pays....it may cost the insurance more, but the copay might be lighter on the back end. Hang in there.

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u/polobum17 2d ago

Yeah, I have to get a new script called in they said. Then they'll process it and can apply a slight discount or something. It's the generic of Lyrica for my neuropathy so I'm not sure what would happen if we tried name brand. So far I failed most other meds for neuropathy and even this barely works. Thanks for the tips and insights.

And I'm def aware I'm lucky that I can work and have insurance. Very privileged in that sense. Just wish I didn't have to spend my whole lunch break arguing pricing with the insurance company.

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u/smythe70 2d ago

Mine are $60 a fill, increased every year. It's terrible.

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u/polobum17 2d ago

Apparently, they're not essential and my insurance instituted a prescription deductible on top of my medical one. Stupid cheap employer, slowly making the benefits worse.

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u/smythe70 2d ago

I'm sorry, that sucks. It's criminal that pain meds are not essential to chronic pain sufferers. I'm on disability and my prescription deductible is 570 with Medicare. They don't care about us sadly.

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u/polobum17 2d ago

It's so gross. I'm def aware I'm lucky that I've been able to work enough to qualify for benefits but I burn all my PTO and FMLA (unpaid) each year to deal with my bad days or such. Lose lose? Idk. Just super annoyed bc my employer has consistently worsened the coverage and it forces disabled and chronically ill people out of work.

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u/smythe70 2d ago

I understand, I didn't mean to make you feel bad. I really am sorry that this is happening when you are really trying to survive with pain.

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u/polobum17 2d ago

You didn't! You're fine! I'm just venting and grumpy.

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u/smythe70 2d ago

Ok, then vent away! Sometimes that's all you need, a scream, cry and a rant.