Xeloda High Deductible

Has the doctor completed an authorization request for the medication? that could be the issue. Also you can call your insurance company to find out why the cost is so high. Usually a deductible is the same for all meds. Meaning if your always had a $400 deductible with non chemo meds you would still have the same deductible. it is unusual to have a deductible on certain medication and not others. It is likely that an auth is needed or even a teir reduction. I would say call the number on your insurance card to see what your benefits are also ask if your insurance has any form of care management program, this could be very helpful. Hope this helps some! Also if the $400 is your copay for the medication and you can't do a tier reduction check needymeds.org they have many programs to help with copay, meds etc. I was a care manager for a very large insurance company ( mostly worked with the medicare members) for many years. There are a lot of options to help it's just hard and overwhelming to know where to look, what questions to ask etc. since DH was diagnosed my previous experience working as a medical care manager in the insurance has helped us and save some sanity. Good luck!

Definitely check needymeds.org. You will be able to go to the medication and then it will liknk you to all manufacturers assistancesprograms. I just looked and there are several that may be able to assist you.

My deductible for Xeloda was going to be around $700.  The Onc office ended up.giving me samples.

Capecitabine, the generic of Xeloda, is long off patent now. 

I am surprised that insurers or stores have not lined up mail order supplies for a good price, like the Walmart cheap generics.  In large parts of Asia the full retail prices (no insurance at all) run about $2-$4 per 500 mg tablet. That is $168 - $336 for 84 tablets, usually a more than full dose for the two weeks on dose of a 3 week cycle, no insurance at all. 

Pharma and insurers are a ripoff if you're paying so much.  I'd seriously look for a better deal locally and abroad.  Maybe you just need to ask for the generic prescription.

Sunnydeecat said:

Has the doctor completed an

Has the doctor completed an authorization request for the medication? that could be the issue. Also you can call your insurance company to find out why the cost is so high. Usually a deductible is the same for all meds. Meaning if your always had a $400 deductible with non chemo meds you would still have the same deductible. it is unusual to have a deductible on certain medication and not others. It is likely that an auth is needed or even a teir reduction. I would say call the number on your insurance card to see what your benefits are also ask if your insurance has any form of care management program, this could be very helpful. Hope this helps some! Also if the $400 is your copay for the medication and you can't do a tier reduction check needymeds.org they have many programs to help with copay, meds etc. I was a care manager for a very large insurance company ( mostly worked with the medicare members) for many years. There are a lot of options to help it's just hard and overwhelming to know where to look, what questions to ask etc. since DH was diagnosed my previous experience working as a medical care manager in the insurance has helped us and save some sanity. Good luck!

My insurance plan has three classes of drugs that it covers and the deductibles are different for the different classes.