Insurance trouble with Imbruvica

[Retiredman]

I have Waldenstroms and have been on Imbruvica (420mg per day) so thats 90 capsules per month for 1 year and it is working great for me. I have a cadillac plan with United HealthCare and have been paying a $10 co pay for the last year. I just got a letter that advised me that they will only pay for 30 capsules a month or 140mg. per day. I will then have to cover the cost of the other 60 capsules. I can't afford that! Has anyone else had this problem. Very worried.

[Hidden]

they want you to take the 420 mg tablets in the 28 day pack Thats how i get mine and my insurance works. that will work. also is medicare part d your primary and then your caddilac plan pays the rest after part d co-pay?. I suggest you just get the 28 day 420 mg pack and avoid the hassle

[Mkmund in reply to Hidden]

I agree

[Retiredman in reply to Hidden]

I am 62 so I am not on Medicare part D. Diagnosed 14 months ago. Doing well on Imbruvica with several side effects but all very minor. Thanks for the responses!

[Hidden in reply to Retiredman]

then the answer is 28 day pack of 420mg.

[81ue in reply to Retiredman]

Ivotedfornixon has a good recommendation - The price is the same for imbruvica tablets whether 140 mg or 420mg or 560mg. If you ask for tablets in your dosage instead of capsules, then your insurance will pay the same price for 28 tablets no matter the dosage, so you can get the 28 tablets in 420mg.

There's no way for insurance to cut costs on 28 days of tablets and therefore no way insurance can cut your dosage.