Humana doesn't cover Rytary?

[Mlitt0818]

Hello. My husband has been prescribed Rytary. He seems to be doing well on the samples his doctor gave him. But we got a letter today informing us it isn't covered by his policy. Anyone else having this problem?

[Hidden]

I've never taken it but I heard a neurologist at a conference I got to go to say that the biggest problem with it is that no ins will pay for it.

[Mlitt0818 in reply to Hidden]

Well, great. Why get someone started on it if that's the case?

[Serenity_finaly-1]

YES-YES-YES

[Mlitt0818 in reply to Serenity_finaly-1]

Do you have Humana?

[Serenity_finaly-1 in reply to Mlitt0818]

United healthcare.

[Hidden]

Humana does not pay regardless approved or not.

[Mlitt0818 in reply to Hidden]

So who "approves" it? The letter does say it has to be approved. I understand they may not approve it, but you're saying even if they do, they don't pay? How does that work?

[Hidden in reply to Mlitt0818]

Humana is the lowest rated insurance company according to soc sec.gov.

that was several years ago when I first looked into insurance. I am confident their rating has changed very little. They do not want to pay, approved or not approved. It does not matter, not who approved but what Humana is willing to pay for.

[Mlitt0818 in reply to Hidden]

But my question is who do they submit it to for this approval?

[Mlitt0818 in reply to Hidden]

Also, is any other company better?

[Hidden in reply to Mlitt0818]

My wife and I have been invited by our pharmacist to come to their office during this month of Cctober and they will make recommendation

[Mlitt0818 in reply to Hidden]

Sorry, I don't understand what that means?

[Boyce3600 in reply to Hidden]

I know there are different Humana plans . Is this one you speak of thru a former employer?

[Mlitt0818 in reply to Boyce3600]

No, it's just the Medicare Part D.

[jackedmonston in reply to Mlitt0818]

If you go to Medicare.gov and look around, you will find a drug calculator that lets you type in all your drugs and the provided you with a list of all the Part D plans available in your state and how much they will cost you out of pocket for a year. When I did this last year, the lowest cost plan (Humana) cost me about $3,500 out pf pocket and the highest (Blue Cross) was about $10,000. It is the time of year when one can switch plans, so it would be good to dp it now.

[Boyce3600 in reply to jackedmonston]

Thank u so much. I hate insurance companies. What they cover one year they msy not the next and don't seem to care if they switch in midstream. They know we r at their mercy.

[Mlitt0818 in reply to jackedmonston]

Thank you so much for this info! Guess we'd have to find out which one, if any, pay for Rytary.

[Bailey_Texas]

Mine does pay for ROpinirole

[Mlitt0818 in reply to Bailey_Texas]

Is that similar?

[Bailey_Texas in reply to Mlitt0818]

No Rytary is Carbadopa levedopa, Repinirole is a dopamine agonist.

[Mlitt0818 in reply to Bailey_Texas]

This is the first drug for us they've refused to pay for.

[Bailey_Texas in reply to Mlitt0818]

First for me too.

[horsplay]

I have humana. They have been paying for my rytary since it first came out.

[Mlitt0818 in reply to horsplay]

horsplay, are you on a part D, or other kind of Humana policy?

[horsplay in reply to Mlitt0818]

I have humana gold plus, a medicare plan with prescription drug coverage. When I first got the prescription, my dr had to go through the prior authorization process. They approved it with no problem. However I have heard that the assistance program at myrytary.com is good.

[Mlitt0818 in reply to horsplay]

Well, hopefully they will approve it with the doctor's help. Thanks!

[shellbinns67]

I have been taking Rytay since 2015. I get it from Impax Pharmaceutical, the manufacturer. They have an excellent patient assistance program, and their customer service is equally as good. You, of course, must fill out an application, and if it is approved, they will provide you with options on paying for it, and you don't have to be poverty-stricken to be approved. I have not had to pay for it yet. Contact: 877-764-9021 or rytary.com/patients-resources. Good luck. If that does not work out for you, I would try GoodRX.com.

[Mlitt0818 in reply to shellbinns67]

Thank you for the info! Will be checking into this.

[Sleeplessparki]

Hi Mlitt, I’ve been taking Rytary for a couple of years and have Blue Cross as my insurance provider. I started out only paying a $10 dollar co-pay but then it went to $50 co-pay after a year. Still not bad in the scheme of things. However, it’s probably only a matter of time before they take it off the reformulary list and not cover it. To bad your insurance doesn’t cover it because it works well for me!

[Mlitt0818 in reply to Sleeplessparki]

Thanks for your reply! We aren't sure whether they will pay for it yet. We got a letter saying it needed authorization. RoyProp said even if it's authorized, they won't pay. My question was who does the authorizing? If it's just an internal authorization from Humana, then I figure they will refuse it. But if it's some sort of paperwork from the doctor, saying it's the only medicine that is working for my husband, maybe there's hope. Just have to find out what they say in ten days.

[ssnowhite]

Yes I had this same problem-...IF you are in US and on medicare, Aetna does have a plan that includes coverage for both Rytary and Azilect. IF US and not on medicare, I URGE you to go to manufacturer's site: myrytary.com/ You may well qualify for one of their cost reduction options; it is well worth the time. i am watching the foreign mail order Pharma supply sites for either Rytary or Numient (European name for drug) to appear...good luck

[Mlitt0818 in reply to ssnowhite]

Thank you so much. We are waiting to see what Humana "rules". They said it takes ten days. Most things I read say they won't pay for it. If they don't, we will go from there.

[MBAnderson]

GoodRx @ Walmart; $252.81. Prices and coupons for 90 capsules of Rytary 23.75mg/95mg

[Mlitt0818 in reply to MBAnderson]

Thanks for the info.