WellCare Plan D specialty pharmacy

[Jewelrylady]

My husband had Aetna Silverscript Part D and was using BioPlus specialty pharmacy for abiraterone. He switched to WellCare Part D and is having trouble getting his abiraterone prescription to the right department. When he’s called WellCare, he’s just been shuffled around and no one seems to be able to let him know if they received the prescription from the doctor. He is approved for financial assistance through PAN Foundation. Has anyone been able to get their prescription transferred to WellCare and get hooked up with the specialty pharmacy?

Also, YMCA has a Livestrong exercise program for cancer patients. I’ve left two messages and no one has called back. Anyone participating in this program?

[Survivor1965]

Yes I also switched to WellCare. They use Express Scripts for processing and Accredo Specialty Pharmacy for drug fills.

I bypassed WellCare and moved directly to Express Scripts. I gave my doc the ph # to Express Scripts and asked them to send the script and they did. Express them sent it to Accredo and it is now in processing.

Hope this helps.

[dhccpa in reply to Survivor1965]

So on Wellcare (I just got the Classic Plan D), if you MO prescribes AA, you can't get it through local Walgreens?

[Survivor1965 in reply to dhccpa]

Sorry, what's AA?

[dhccpa in reply to Survivor1965]

Abiraterone Acetate (AA). Sorry, I don't use as many acronyms as some. But that one I slip into frequently!

[Jewelrylady in reply to dhccpa]

Are you getting any financial assistance to cover cost? I think AA may be Abiraterone

[dhccpa in reply to Jewelrylady]

Yes it is abiraterone. I don't get financial assistance. I'm just asking if it can be filled at a local Walgreens.

[DrawingSnowmen in reply to dhccpa]

You can get the generic abiraterone at Walgreens.

[dhccpa in reply to DrawingSnowmen]

Great!

[Jewelrylady in reply to DrawingSnowmen]

Do you know how much it costs at Walgreens

[Survivor1965 in reply to dhccpa]

Most of these expensive cancer meds are handled thru a specialty pharmacy. In this case Express Scripts/Accredo. I don't think its something that the Walgreens/CVS places handle.

[dhccpa in reply to Survivor1965]

Interesting. It's just pills, and generic AA is cheap these days.

[Jewelrylady in reply to dhccpa]

Do you know how much it is?

[dhccpa in reply to Jewelrylady]

Generic AA is about $100-$150 for a months supply with a GoodRx or Singlecare last time I checked. I'm in Florida.

[Jewelrylady in reply to dhccpa]

That’s not bad at all. I’ll have to see what it costs here. Thanks for letting me know!

[Jewelrylady in reply to Survivor1965]

Do you still have phone number to Express Scripts? Also, my husband thought the specialty pharmacy name is Acaria . Is Accredo correct. Thank you so much for your help.

[Survivor1965]

Hi, yes its Accredo for sure, thru Xpress Scripts. Number 8337500201

Good luck

[Jewelrylady in reply to Survivor1965]

Thank you! Do you think Express Scripts contacts PAN Foundation for verification of financial assistance?

[hfl20 in reply to Jewelrylady]

Yes, I'm sure they would initially until it is setup in their computer network. I use Wellcare Part D and receive my Orgovyx from the MD Anderson specialty pharmacy. The pharmacy calls me every month prior to shipment and if not already processed through the Pan Foundation for copay, they do it within a few seconds while I am on the phone.

[Jewelrylady in reply to hfl20]

I hope things can go this smoothly for my husband once he can get everything set up. Before he switched drug plan for 2024, he was using BioPlus for abiraterone and they called monthly to set up mail delivery.

[Survivor1965]

No. In order to get copay assistance thru PAN you have to get a grant then they send you a copay card for the Pharmacy. When you call for a refill you give them your PAN info at that time

[Jewelrylady in reply to Survivor1965]

He’s already been approved with Pan Foundation. His doctor sent electronic prescription to WellCare but when he calls WellCare to confirm it was received he keeps getting shuffled around and no one can give him an answer. He is beyond frustrated. I gave him phone # to Express Scripts so hopefully he will call them.

[Survivor1965]

If he calls Express Scripts that is the way to go. I just did it 2 days ago, it was easy. Let know how it goes.

J

[Jewelrylady in reply to Survivor1965]

Are you in California. They might use a different specialty pharmacy in other states or cities.

[Survivor1965]

AZ

[GoBucks]

I had a PAN grant. My scrip was at Walgreens and I had no troubles, but my drug insurance at the time was not through Wellcare. I hate when crap like that happens.

[Jewelrylady in reply to GoBucks]

It shouldn’t be this complicated! I hate it, too!!!

[j-o-h-n]

AI will solve all of the confusion and chaos... They will send you the ingredients for you meds and you'll have to fill those tiny tablets using a beer comb.....

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 01/04/2024 7:14 PM EST

[Jewelrylady in reply to j-o-h-n]

Hopefully ingredients will include red wine and a good amount of sugar🤣

[Don_1213]

Just a small suggestion: ExpressScripts has a fairly decent website where you can setup your profile and manage your prescriptions using the website. I ended up with a mix of mail order via ExpressScripts and local Acme pharmacy which was MUCH less expensive than the mailorder. Plus the mailorder can't do Repatha (has to be refrigerated) that my cardio guy has me on. It had to go to a local pharmacy that had a refrigerator.

Drug plans in general: One thing I learned - if you don't shop the drugs around you're going to be paying too much. Despite emails begging me to switch prescriptions to mail order from Express scripts, the mail order co-pay was frequently 4X the local pharmacy and more than I could buy the meds outright (no insurance) using GoodRX coupons.

Cigna started last year moving a lot of generics - common ones - to "Tier-2" where there was a co-pay. That intensified when I put my drugs in the Medicare drug pricing website to see what 2024 would cost. The Cigna plan cost/month more than doubled, the co-pay doubled and more drugs required a co-pay.

The Medicare site was very useful in comparing plans, and I ended up with an aetna plan, low per month cost, zero cost for mail-order generics and "preferred generics" - and the drugs with co-pays are much cheaper using the Acme pharmacy than their mail-order (which is "CareMark" AKA CVS).

It really is in your best interest to use the Medicare website every year to see if you're getting the best deal. It is a PITA to have to inform all the doctors offices that you're switching plans, and tell them which drugs to send for mail-order and which ones to fill locally, but doing that will save you $$$. GoodRX.com and Drugs.com are both on my favorites bar in my browser.

[Jewelrylady in reply to Don_1213]

I will call Express Scripts and see if they cover California. We did look at Medicare website to compare plans and WellCare looked good, but dealing with them has been very difficult. I really wish we’d left our old plan in place, but too late now. With the other plan we had everything approved and set up in a day and he didn’t have to pay anything for abiraterone. Thanks for your suggestions. I may also call CVS to see what cost would be.

[pe43]

I'm also taking abiraterone and have Wellcare for my part D insurance. Since abiraterone is a generic, you can get it much cheaper by using one of the online suppliers. I use GoodRx.com, enter abiraterone on their website and they'll tell you the cost at pharmacies near you - the variation in cost can be enormous! GoodRx gives you a coupon which you take to your pharmacy of choice and tell them you want to bypass your insurance company. Currently I pay about $160 for 120 250mg tablets (30 days supply); my first month's cost using Wellcare was $2350 two years ago, but then I discovered GoodRx. Several people on this forum have pointed out that costplusdrugs.com is even cheaper than GoodRx. Any questions, let me know.