Medicare & AARP supplement wont pay for "diazepams"

amontro · July 2011

I was told by my pharmacy that my Medicare and AARP supplemental insurance won't pay toward my lorazepam 0.5 and I have to pay full price. I understand from AARP that they won't pay toward anything like that, even Xanax. I take lorazepam for my anxiety and just one pill takes the edge off without my getting sleepy during the day.

Do any of you know of any type of these meds that Medicare/AARP would pay toward?.

LisaAlissa · July 2011

Probably the best way to get this information is to call your insurance company's customer assistance line and ask a copy of the formulary associated with your policy's prescription benefit.

I understand that there are at least a couple of companies that write AARP-endorsed supplement policies, and these can vary state by state as well. So to get a helpful answer from us, you need to tell us a few things:

Name of the Insurance Company

Name of the Policy

State where the Policy was written

With that information, you might get helpful info from someone who has the same policy, but I really think it will be easier to ask for a copy of the formulary.

HTH,

LisaAlissa

Fearless_One · July 2011

Have you inquired as to what the full price is? You may be surprised at the cost. Lorazepam (Ativan) is pretty cheap....

mrsnjband · July 2011

Those kind of plans don't usually pay for medication. Do you have a senior medicine plan?

Fearless_One is right, the generic isn't that much. Hope you can figure something out. NJ

cycle-path · July 2011

Here's a site that has 2mg Lorazepam, quantity 100, for $22.35. Shipping is probably extra.

Ask your doctor to prescribe a high dose and then cut the pills in halves or quarters yourself. That's a cheaper way than buying the low dose. (DH gets his meds from the VA and that's what they do with him -- they even sent him a pill cutter.)

www.healthwarehouse.com

Medigal · July 2011

When I checked into AARP for my Medicare supplement plan I think it was managed by United Healthcare and when I compared it to other plans I closed the door to buying it. This is so ridiculous to refuse to pay for such a cheap med like Ativan especially since it is generic! I would complain to AARP and insist "they" check into this. If they won't pay for the cheapie drugs, I hate to think what they will refuse to pay for with other meds! Like other posters have written, thank goodness the cash price on the generic is not expensive so worse comes to worse, you might have to pay for it yourself until you can do something about AARP's rules. My Medicare Advantage Plan pays for Clonazapam which is in the same type drug category. Why don't you check and see if they cover that one? If they do, there is no reason Ativan should not be covered, imo.

dogeyed · July 2011

Dear Amontro,

My clonazepam (Klonopin, one of the diazepams) only costs $10 and change, at my Kmart pharmacy, which I don't get any extra savings from them other than it being Kmart. Luckily the tranquilizers are not costly at all when you pay straight price. I also have Medicare A&B and the AARP drug plan. But one of the reasons I chose it is because the cost on Lyrica (nerve pain-killer) for my back problems is much less than full-price and costs on other plans, my price is less than $50. So, I feel sure you can afford your tranquilizers, since it's as cheap full-cost as the lowest co-pay around.

GG

Chickadee · July 2011

I wonder if this is a disagreement between generic and brand name. It could be that her insurance is insisting on the generic, but she hasn't come back to discuss this any further.

dogeyed · August 2011

Chicadee, might be, but I have the identical insurance, and since they won't pay for it, she'll get it at full price, that's what I pay, which happens to be as cheap as the lowest co-pay of $10. Now, if her doc insists she only gets the brand name, she can simply ask him to change it to generic and call in a new script, or she could even ask the pharmacist to give her generic after calling her doc. Or if her insurance will only pay for brand name, same thing, she can contact her doc if he ordered generic. GG

Chickadee · August 2011

This issue for me was my 86 yr old mother. She relied on a statement by a pharmacist in the '60's who said all generics were sugar pills. She wouldn't let go of that belief no matter who talked to her or what articles I could give her.

Most pharmacies now will default to generic unless the Dr. specifically requests and notes brand name only. So lot's of battles with my mother and lot's of return trips to the pharmacy. <sigh>

cycle-path · August 2011

Chickadee, this won't help you with your current situation, but for the future, you might try sending a letter to each of her doctors explaining her issue with generics, and ask them if they will simply prescribe her medicines by their chemical name rather than their brand name. (I guess it might also help if the term "chemical name" or "bioequivalent" were used with her, instead of "generic.")

amontro · August 2011

Thanks for the answers. I am new to Medicare/AARP supplement plan (affiliated with United Healthcare). For years, I have been getting Ativan's generic lorazepam via med insurance from work, costing about $7. Now they want to charge me $42. I've called AARP and as I originally stated they will not let me have any diazepams or anything like them including Xanax.

I appreciate all the advice. I will look at getting some of my prescriptions online, or pay the $42 because it's worth it.

I just received a letter from Medicare. They allowed me to fill a prescription for Zofran (onandestrone) for $7, but next time I will have to pay full price because it is not covered. Zofran is not a diazepam - it's for cancer nausea. I have to find our what they will charge for that.

BTW, when I called about lorazepam, I asked how I could find out what meds they would cover and they said I would have to call them every time.

LisaAlissa · August 2011

United Health Care has an on-line pharamacy resource you may find useful:

https://www.unitedhealthcareonline.com

(since the link generator is grayed out for me and pasting seems to be disabled), I'll describe what to do when you get there instead of making a typo while trying to type the specific address.) On the right, you'll see a "most visited" list, which includes "Prescription Drug Lists." When you click on that, you'll be taken to another page. When you get there, on the left (but in the main part of the page) you'll see "Information by Product & Affiliate" and click "Medicare" off that list, which will take you to yet another page. On that page, you'll see the various Medicare plans that they offer. You'll need to check yours for the specific name of the plan which was marketed to you using the AARP name.

Eventually you'll get to a formulary which you can get for your specific plan.

HTH,

LisaAlissa

Medicare & AARP supplement wont pay for "diazepams"

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