To help guide you and your caregivers through the planning process, Transplant Pharmacist Erin Ticehurst, Pharm. D., BCPS shares three steps to help you and your caregivers assess your current prescription plan coverage:
- Check the formulary
- Learn the co-pays
- Call Penn with questions
Does my plan cover my medications?First, check to see if your prescription plan covers medications that are frequently prescribed after liver transplant. Prescription plans call the list of medicines covered for their members a formulary. If a medicine is not on the formulary of your prescription plan, the cost of the medicine is your responsibility.
Co-payment and formulary information can be found:
- on your insurance company’s website
- on paperwork provided to you by the insurance company; or
- by calling your insurance company directly.
Before you check your prescription plan’s formulary, be sure to have ready the following list of medicines and supplies that are commonly required after a liver transplant.
- Mycophenolate mofetil (Cellcept®)
- Azathioprine (Imuran®)
- Tacrolimus (Prograf®)
- Everolimus (Zortress®)
- Intravenous Ganciclovir
- Fluconazole (Diflucan®)
- Sulfamethoxazole/Trimethoprim (Bactrim®)
- Blood glucose meter
- Testing strips
While the above list covers the medicines and supplies that are most commonly needed after a liver transplant, it’s important to remember that some conditions, such as high blood pressure or infection, may add to the medications listed above.
How much do they cost?After you’ve confirmed the medicines are on your prescription plan’s formulary, the next step is to look at the monthly co-payment for these medications and think about whether the cost is within your monthly budget or whether it is more than you expect to be able to afford.
If the monthly co payments are more than you expect to be able to afford, or the medications are not covered by your insurance, let your liver transplant social worker know and they can help you come up with possible solutions to issues you’ve identified.
If your prescription plan is through Medicare Part D, the gap in prescription coverage called the ‘donut hole’ is an important issue to consider. Although this issue is expected to resolve in the future, it won’t be entirely solved until 2020 so it is important for you to keep track of your prescription medication spending so you can plan accordingly. If you are in the donut hole around the time of your transplant, you will need to have money set aside to ensure that your medications can be paid for.
Let Penn helpOnce you’ve assessed your prescription plan, if there are any changes to your plan or your health insurance, it’s important to contact your transplant coordinator to let them know about any changes.
If coordinating this part of your pre-transplant plan feels overwhelming, remember, the Penn Liver Transplant Team is here to help. With one of the most experienced teams in the greater Philadelphia region, our team is often aware of resources that can address prescription medication issues.
If you have questions about the information you learn from your prescription drug provider, call your liver transplant coordinator, or send them a private message through the myPennMedicine online portal, and together we’ll work with you to explore the options and resources available.