Co-pay increase for my PPI - Acid Reflux / GERD Message Board

MountainReader · 02-01-2007, 10:21 PM

I went to refill my Prevacid yesterday and found that my co-pay has increased from $25-$50 for the new year. This increase along with two others that just went up this month brings my monthly co-pay total to $375. I can't afford this long term. I checked my insurance and with the new changes only Prilosec OTC and Protonix ($25) are formulary.

When I started having acid problems, I took Prilosec. Eventurally I went on Protonix and took it for about 3 years until it stopped working. I then tried Nexium with limited success. Finally...last spring, I was put on Prevacid Solutabs twice a day. I have had good results with this current treatment.

I am very frustrated and trying to make decisions on my personal health care and what I can afford. Any suggestions?

aswander · 02-02-2007, 04:43 AM

One word - appeal. Use the appeal process, and keep appealing. I had to appeal twice in order to get my insurer to continue covering Nexium after dropping it. Write up a letter, put your history in it, go find some studies that back up your claims, then have your doctor sign it. Then send it in and make sure you send it certtified.