Sigh. Well, for a brief shining moment my pharmacy troubles were over. But now I am back where I was a year ago, with a letter from the insurance company telling me that they won't let the pricey Gilenya count toward my deductible, because I'm not the one paying for it (the co-pay assistance organization is).
It's okay: it means that the MS medicine is in a separate financial box, and is still covered up to $15,000 a year by the lovely co-pay assisstance people. In the future I pay all the parts my insurance doesn't cover (around $1,000 a month) and then that amount is reimbursed. If I had some catastrophic accident that would still satisfy my deductible. (The deductible went up 25% last year, as well.)
So, essentially, I'm in the same situation as everyone else, paying high premiums for a high deductible I will hopefully never use.
Amusingly, just with his normal medication and a colonoscopy, Gary came a few hundred dollars away from his deductible last year. I take some vindictive satisfaction in that.
And for all who say, "That's outrageous, you're still paying the money, why would the insurance company care where the money comes from," read the article on the new law in Virginia and West Virginia that make these insurance shenanigans illegal. The insurance company claims it has to do this to shine a light on the high prices charged by the drug companies.
I feel a little like a child of divorce, with Daddy Drugs and Mommy Insurance fighting over who is best as taking care of me, and I'm caught in the middle.