prescription max?

[anonymous]

Help! I am so upset and frustrated right now. I just found out that we met our prescription maximum for Allie's meds and now nothing is covered until 1/01/06. She had one treatment of TOBI and this put us over the maximum. Wow. I'm not sure what to do.

Does anyone else have this problem and what do you do about it? I'm not sure how we will pay for her Prevacid and enzymes until January and lord help us if she has to go pn TOBI again. What do people do when they are on TOBI regularly???

Any help or advice right now would help me out a lot! I want to crawl under a rock and hide from all these problems. Money should not be an issue when you have a sick child.

Thanks,
Amy
mom to Allie 4w/CF and Betsy 16months w/out

 

[anonymous]

Sounds like you may need to go to the TOBI foundation for help. They will help pay for what your insurance won't pay for (charging you a small co-pay - ours as $15/month rather than over $500/month that our ins. wouldn't cover). This max. thing is another one of the wonderful things that insurance companies are doing to save money...

 

[anonymous]

My Ins. carrier denied TOBI because I have a 5,ooo. prescription max per year. The cost of Tobi for 28 day supply is $3,350.00!!!! I was sooooo worried because I have been culturing psuedo and was afraid I would have to do without.......and get sicker!!!!! My social worker hooked me up with the TOBI foundation! The number is=1-877-862-4423. They are very helpful. They will fax you a form to fill out. You just need to fill it out and fax them back your w2's. You will get approved right away(hopefully)(unless you are a millionaire- that's the only people who can afford to pay that every other month). They set up your RX with the CF services pharmacy. I've never used them until now- and I only use them for the Tobi. The foundation pays the pharmacy directly. Everything went pretty smoothly!