# Medicare Part D denial



## Lolly (Jul 26, 2017)

My husband underwent a radical prostatectomy in April.   He went to the urologist yesterday for a follow up visit.   The Doctor has prescribed a drug called Cialis and has advised him that it will improve blood circulation to that area and protect urologic health..   Now mind you... this was NOT prescribed for ED... but for proper healing and maintenance of blood flow and Urinary continence and to prevent tissue death.    Problem is.. Medicare will not pay one single penny toward it as they consider it to be an ED drug PERIOD...  Blue cross does have an appeal process, but getting it approved is unlikely.    For us to purchase a 30 supply would cost $450 per month out of pocket..    We have looked into purchasing the medication from Canada and the price for 30 days would be $31.50..    CAN YOU BELIEVE THAT?  What is being done to the American people is disgusting.   How can the prices be so different?   Why are Americans expected to shoulder the HUGE profits for the Drug companies?   I'm really pissed..  I have heard about this happening, but this is the first time I have had first hand experience.. 

Has anyone encountered this with Medicare Part D and been able to get them to approve a medication?   Has anyone ordered medication from Canada?   Is there a lot of red tape involved?  I'm flabbergasted at this.


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## Don M. (Jul 26, 2017)

Much of the difference in price for Cialis...between here and Canada...can be attributed to the cost of the TV ads that Cialis hosts.  These TV ads cost the drug company 10's of thousands of dollars per minute...and those who buy these drugs are paying for those ridiculous TV ads.  It is Only the U.S. and New Zealand which allow this propaganda to be broadcast.  If you, or anyone wants to see prescription drug prices reduced here, a real good place to start would be to contact your Congress representatives and demand that they sponsor legislation that would ban these ads on TV.


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## Trade (Jul 26, 2017)

Don M. said:


> Much of the difference in price for Cialis...between here and Canada...can be attributed to the cost of the TV ads that Cialis hosts.  These TV ads cost the drug company 10's of thousands of dollars per minute...and those who buy these drugs are paying for those ridiculous TV ads.  It is Only the U.S. and New Zealand which allow this propaganda to be broadcast.  If you, or anyone wants to see prescription drug prices reduced here, a real good place to start would be to contact your Congress representatives and demand that they sponsor legislation that would ban these ads on TV.



Dude, there is no way advertising costs justify an increase of 1,428% from $31.50 to $450. 

We are talking about pure unbridled greed on the part of the drug companies, and our government not only allows it, but enables it.


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## Butterfly (Jul 26, 2017)

Lolly said:


> My husband underwent a radical prostatectomy in April.   He went to the urologist yesterday for a follow up visit.   The Doctor has prescribed a drug called Cialis and has advised him that it will improve blood circulation to that area and protect urologic health..   Now mind you... this was NOT prescribed for ED... but for proper healing and maintenance of blood flow and Urinary continence and to prevent tissue death.    Problem is.. Medicare will not pay one single penny toward it as they consider it to be an ED drug PERIOD...  Blue cross does have an appeal process, but getting it approved is unlikely.    For us to purchase a 30 supply would cost $450 per month out of pocket..    We have looked into purchasing the medication from Canada and the price for 30 days would be $31.50..    CAN YOU BELIEVE THAT?  What is being done to the American people is disgusting.   How can the prices be so different?   Why are Americans expected to shoulder the HUGE profits for the Drug companies?   I'm really pissed..  I have heard about this happening, but this is the first time I have had first hand experience..
> 
> Has anyone encountered this with Medicare Part D and been able to get them to approve a medication?   Has anyone ordered medication from Canada?   Is there a lot of red tape involved?  I'm flabbergasted at this.



I haven't had to do it myself, but I know several people who do. They are quite happy with the arrangement and have no problems at all with it.  The Canadian pharmacies just require them to mail (or scan, I think, but not sure) in their original prescription and the get the prescription by return mail.  From what they've told me, there's no red tape.  Call the Canadian pharmacy and talk to them; most of them have 800 numbers.

As to arguing with Medicare about a prescription, we tried to argue with Medicare about a particular blood pressure med she needed because the substitute made her ill, but no dice.


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## Lolly (Jul 26, 2017)

Butterfly said:


> I haven't had to do it myself, but I know several people who do. They are quite happy with the arrangement and have no problems at all with it.  The Canadian pharmacies just require them to mail (or scan, I think, but not sure) in their original prescription and the get the prescription by return mail.  From what they've told me, there's no red tape.  Call the Canadian pharmacy and talk to them; most of them have 800 numbers.
> 
> As to arguing with Medicare about a prescription, we tried to argue with Medicare about a particular blood pressure med she needed because the substitute made her ill, but no dice.



I think we are going to go the Canadian route...  Just talked to our Blue Cross agent and also another person who used the Blue cross exception method... and even with the exception, that medication would be over $200 a month...     Isn't it a shame that Seniors who have worked and paid taxes for all these years have to turn to Canada for help with medication?


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## Trade (Jul 26, 2017)

Lolly said:


> I think we are going to go the Canadian route...  Just talked to our Blue Cross agent and also another person who used the Blue cross exception method... and even with the exception, that medication would be over $200 a month...     Isn't it a shame that Seniors who have worked and paid taxes for all these years have to turn to Canada for help with medication?



It's a travesty. Canada does health care much much better than we do and we should emulate them.


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