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Anthem Blue Cross PPO $35 Copay GenRx Plan
Jan 30, 2012

I'm in a predicament. I'm about to get a raise at work that will put my annual salary between $50,000 and $60,000 per year which will disqualify me for ADAP that I currently use to get my meds in California. The only Health Insurance plan offered by my employer is the above mentioned and it does not include Name Brand Drugs. Since there is no generic form of Truvada or Isentress (the drugs I take now), what can I possibly do? Since those drugs cost over $22,000 per year, would I really have to pay that out of my own pocket 100%? Should I try to convince my employer to offer a different health insurance plan (it's a small group employer)? What happens when your employer offers health insurance but not a plan that actually works for your circumstance? Thank you for your time.

Response from Mr. Chambers

That is the big drawback to getting health insurance through your employer. You don't have a say in what plan is offered. If you are comfortable doing so, talk to your employer about it. Based on what you have described, if you are not eligible for ADAP and your plan does not cover brand name jobs (that's really cheap on your employer's part), then, yes, you will be expected to pay 100% for your brand name medications.

I'm sorry I don't have an alternative.



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