VA - Xtandi Follow-up

[BrianF505]

Below is a post I made in another thread 23 days ago. Today is my follow up-

Original Post-

For the Veterans out there, you may be able to run your meds through the VA Health System. I’m working on that now, to include my Xtandi. It’s still in process and I’m having to jump through hoops, but I have hope it’ll all work out.

I’m a Cold War Vet (76-79) and never thought I’d be eligible. However, Vet friends of mine encouraged me to apply. And “Whoa, Look Out Bobby”, low and behold, I’m accepted. I have to pay co-pays (due to wife’s income), but they’re ridiculously inexpensive compared to Medicare/private insurance. I now have VA Primary care doc and a Urologist who’s working with me to get oncologic drugs through the VA. So far my experience has been 2 Thumbs up. So you vets out there, give it a shot.

Follow up-

My first round attempting to get VA coverage for my Xtandi failed. The pharmacist cited criteria was not met. Essentially, in my case, there just wasn't enough documentation yet in my VA file. This was due to my recent acceptance into the VA system and a change of non-VA oncologist.

My advocate (and new bestest friend) the VA urologist suggested I dig up other office notes, etc. to show what treatments I've done. And I did. These additional office notes from my prior oncologist in Los Alamos\Albuquerque were submitted to VA doc who then appealed the original non-criteria decision. In took a bit of time and perseverance but 2 1/2 weeks later, I'm in!!! Woo-whoo! First fill in the mail now. I'm not sure of my co-pay yet, but I'll update that when the bill arrives.

I hope this provides some encouragement tfor Vets to sign up for VA health benefits and to get help with your meds. You can sign up on-line and all you need is a DD-214 and last income tax filing.

[Hidden]

Thanks for the encouragement. I had a neighbor that kept bugging me to apply and I finally did and got accepted around 9 months ago. It's much less expensive than what I had, especially for meds. I'll be going on medicare in 1 1/2 years. I'll get a supplement then and at that point, part "D" will not be necessary with the VA coverage for meds. My doctor has already told me that Xtandi will be available for me when I become resistant. The VA has both Zytiga and Xtandi so you will be covered when you need it.

[ggbk in reply to Hidden]

Gregg, I have been granted a service connected disability because of my PCa and time in Vietnam. I have just started on Lupron and Zytiga with Prednisone and was wondering if you knew if I had to use the VA doctors to get the meds through the VA. I like the doctors I have but the cost of the Zytiga copays with my Medicare is still substantial.

George

[Hidden in reply to ggbk]

Thanks George. So far I've been using the VA for meds, but haven't needed any since I've been with the VA. I'm schedlued today for a CT scan to have my lungs checked out. I was exposed to asbestos when the ship I was on went through a "yard period" where they tore out all of the old asbestos-laden insulation. I definitely have lots of nodules and scarring in my lungs along with a cough so it's a real possibility. I'd like to understand more about the process of applying for a service related disability. Let me know if we could chat privately so as not to use up space here. Thanks.

[ggbk in reply to Hidden]

Definitely. I tell you what I can.

George

[Hidden in reply to ggbk]

Somone told me you just bring your prescriptions to the VA and they will fill them, but I have no direct experience with that. I don't see why the VA docs would not prescribe Zytiga for you.

[BrianF505 in reply to Hidden]

See my response below...

[BrianF505 in reply to ggbk]

I also have a private (non-VA) doc who oversees my care. I had to start with getting a primary care VA doc and setting up an appt. from there I explained my situation and ask for help on getting VA to cover meds. He immediately took care of my Metformin and atorvastatin. But for the rest, he made notes in my chart with referrals to Urology and Oncology. In the end, the oncology group deferred to the Urology doc who pushed everything forward to the pharmacy. I would suggest gathering private doc notes/visits to cover the reasons/criteria for the meds you take. It took me a couple try’s, but it all worked out. And I imagine with your disability rating due to AO, it might be easier.

[jgmcbride]

Great news. I have been using the VA now for some 8 years since diagnosis. Vietnam war vet so it is presumed service connected.

Absolutely wonderful service from the VA doctors and medical staff. I cannot sing their praises enough. Almost anything that I want/ask for I get.

All vets are eligible for VA care. Doesn't matter if it is service connected or not. If not service connected then just a copay (think that it is 8 dollars per month per item). Service connected then absolutely no fees at all.

I encourage all vets to apply even if you do not need the service today. They may close off enrollment in the future and if you are already enrolled you will be grandfathered in.

[BrianF505 in reply to jgmcbride]

Absolutely!

[BrianF505]

Follow up to my follow up... Received 1st month of Xtandi and last week the co-pay came to me at a whopping $22.00! I think I can handle that!

[Shooter1]

I'm service connected for different condition, but no co-pays, just covered all costs related to bilateral orchiectomy, zero out of pocket at private hosp. VA's not perfect, but getting better here in AZ.

Doug