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just an insurance company rant...

Timmyd
Timmyd Member Posts: 317
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in Caring For a Spouse or Partner

This year, my employer changed to the company providing prescription drug insurance coverage. Today I got a letter indicated DW extended release memantine 28mg is no longer a covered. We are instead expected to use the standard version of the pill. So instead of one extended release memantine pill per day we are expected to take the standard version memantine several times a day.

Anyone who cares for PWD in later stages knows how challenging it can be to get them to take their pills. Memantine is used to treat a condition (ALZ) for which difficulty swallowing is known to be a difficult symptom for caregivers. Insurance company telling me we need to take more pills because the option available to take fewer (extended release memantine) is no longer covered has been a gut punch. It feels like the people making these decisions just don't care about the real world impacts they are having on the people dealing this disease….

Comments

  • Chris20cm
    Chris20cm Member Posts: 138
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    For my DW, Pantoprazole solved the dysphagia and after several years it became unnecessary. Not sure if that's an appropriate option for your PWD?

  • Chris20cm
    Chris20cm Member Posts: 138
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    One per day

  • BethL
    BethL Member Posts: 1,305
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    Try GoodRx. They may be able to get you the medication at a decent rate. Ask your pharmacist about it, or google it.

  • Goodlife2025
    Goodlife2025 Member Posts: 271
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    Tim so sorry you are having to deal with this unnecessary change to your wife's medication. plan It must feel very frustrating - insurance decisions often feel like they are just throwing darts and not very well.

  • Chammer
    Chammer Member Posts: 242
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    Check Mark Cuban's Cost Plus drugs. I looked up extended release memantine and a 90 day supply of 28mg was a little over $25.

  • Quilting brings calm
    Quilting brings calm Member Posts: 3,091
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    edited 3:23AM

    I just googled goodrx. You can get a 90 day supply for anywhere between $42 and $75.

    If you’ve never used goodrx.com, just go to the website and enter the medication. They will show you the price at various pharmacies, along with codes that you show your pharmacist. Many pharmacies have goodrx cards with the codes preprinted and they will tell you the price for any drug if you ask.

  • Timmyd
    Timmyd Member Posts: 317
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    Thanks to everyone for the useful advice. I will figure this out. It is a small problem in the big scheme of things. I was having a hard day getting DWs pills down and get this letter the same day telling me our insurance company is going to save themselves some money by trying to make us take even more pills. Advances in medicine such as extended release memantine should be celebrated and promoted. Instead we get financially punished by trying to make even the slightest improvement in our condition.

  • SDianeL
    SDianeL Member Posts: 3,087
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    extended release can’t be crushed but tablets can. Could you crush them and put them in applesauce or pudding?

Commonly Used Abbreviations


DH = Dear Husband
DW= Dear Wife, Darling Wife
LO = Loved One
ES = Early Stage
EO = Early Onset
FTD = Frontotemporal Dementia
VD = Vascular Dementia
MC = Memory Care
AL = Assisted Living
POA = Power of Attorney
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