Bills: Our meds are very expensive, how... - Advanced Prostate...

Advanced Prostate Cancer

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Bills

Doug47 profile image
56 Replies

Our meds are very expensive, how in the shell do we pay it all? My insurance covers 90%. The 10% I have to cover I don’t even come close. Do any of you have any tips or it’s case by case?

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Doug47 profile image
Doug47
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56 Replies
Mkeman profile image
Mkeman

If you haven’t already done so, go to “jjpaf.org” to see if you might qualify for free meds based on your income. (Johnson and Johnson Patient Assistance Fund.”)

Tekton profile image
Tekton

Oh my gosh! I've been thinking about same problem. I don't even have insurance anymore. Hopefully I can get it again in January. Currently getting help from u.w. until then.

System is seriously broken.

Tall_Allen profile image
Tall_Allen in reply to Tekton

Why can't you get insurance now?

Tekton profile image
Tekton in reply to Tall_Allen

Open enrollment starts in November. I live in a county that most insurance companies dropped individual payer plans. My company does not give insurance plans. I am hoping to find one that covers my doctors.

I lost Medicaid coverage end of March. I am lucky u.w. is taking care of me till I get insurance.

Got any ideas?

Tall_Allen profile image
Tall_Allen in reply to Tekton

I read that insurance company profits increased this year, so you may have more choices in November. Trump delayed implementation of mandatory healthcare by small companies, unfortunately.

Tekton profile image
Tekton in reply to Tall_Allen

Hi TA

I was able to get insurance this year Yeah! That plus financial assistance and I should be ok. Hopefully no more delayed Lupron shots .

johngwilk profile image
johngwilk in reply to Tekton

Most drug manufacturers have patient assistance plans keyed to your income. There's probably a department at the UW that can help you to apply. If you qualify, your cost may be zero.

charlesmeyers1964 profile image
charlesmeyers1964 in reply to Tekton

my cvs pharmacy offers me durgs the expensive if i meet their requirements check with the pharmacy u go thru

ctarleton profile image
ctarleton

If you are on expensive Zytiga, this site might point toward some help.

janssenprescriptionassistan...

Charles

Tekton profile image
Tekton in reply to ctarleton

Not on expensive one yet. I think my med. oncologist is leaning towards a trial drug that appears to be working on Ductal features. I'll find out in November. He knows a company that may pay for it.

Thanks for suggestion.

LDarcy profile image
LDarcy in reply to Tekton

Good Morning Tekton,

Would you mind sharing any details regarding the potential trial? My husband also has a Ductal variation. And, we went to see Dr Chou on your recommendation by the way (I think it was you). He was great to talk with and hubby might switch over for some metronomic chemo.

Thanks

Tekton profile image
Tekton in reply to LDarcy

Hi L,

It wasn't me on Dr. Chou. I think you may already have the most knowledgeable in the country.

I will be happy to share what I learn. My next appointment is early November.

charlesmeyers1964 profile image
charlesmeyers1964 in reply to Tekton

i'm on PROVENGE u might check with that thru your oncologist

YostConner profile image
YostConner

Doesn’t your insurance have an out of pocket max?

Tekton profile image
Tekton in reply to YostConner

I don't have insurance anymore. Two years of $18,000 total medical costs (premium +copay max) wiped out my savings. I made $28,000 last couple years.

SSDI may be only path soon.

YostConner profile image
YostConner in reply to Tekton

I was responding to Doug47, but I see your point. I hadn’t thought of it that way before. Thanks.

in reply to Tekton

I went thru my emergency funds since dx in 2015. Been on SSDi until last month . I didn’t recieve review notice so they dropped me. I’m pending my drs overview of me now. SSDi is poverty living but has helped to keep the lights on. I ve sold all tangible assists. Only coped because no mortgage payments. If APC pops back to take me down I’ll have no extra funds for any special treatments. I’m on Medicare and Medicaid and we shall see how that goes. I’ll take what I get..No matter what we think we are all At at the mercy of the universe. Good luck !

Tekton profile image
Tekton in reply to

It makes me sad to see others in this situation. I can't say I know how you feel, just that I'll be in your boat eventually.

God bless

in reply to Tekton

We are all in different parts of the same ship. You’ve got years of voyage ahead.. Keep rowing and tote that bale...Get back to doing what you love.. Good luck!

Doug47 profile image
Doug47 in reply to YostConner

I need to check on that. I’ve never had to use my insurance like this ever before

in reply to Doug47

You’re going to break a lot of first on this voyage.. it’s a rollercoaster Pallooza! Strap in and hang on! You have a lot of support here.

MichaelDD profile image
MichaelDD

Doug.. I am on SSDI and will "qualify" for Medicare starting in December 2018. I too have paid out of pocket. SSDI was a fast approval under "Compassionate Allowance" . 45 days. I was diagnosed in March 2016. SSDI said they used June 2016 (my DeVinci removal) as the 'set date". SSDI requires a 6 month "waiting", then 24 months after before you get Medicare. Essentially 30 months. During this time I too have had big costs ($35,000+ out of pocket). My Cobra alone is $770 a month. Don't know what Medicare/supplement plan will bring but I will go for what is best because I think I (we) only have a one time shot. Pre-existing after is the stopper for a different plan later. Changing after the choice is said to be almost non-existent with cancer. Thank you for asking the question. Good luck on this journey.

Kimmilemo profile image
Kimmilemo in reply to MichaelDD

If you get plan F Medicare supplement it picks up everything after Medicare pays.

Shooter1 profile image
Shooter1 in reply to Kimmilemo

Except meds. Mine has co-pay at $1200/month with estimated yearly of 9000 with part D rider. Thank

God as a disabled vet copays are $8 even for Xtandi.

.

Kimmilemo profile image
Kimmilemo in reply to Shooter1

You have to have a part D separate medical card. Anywhere from 20 a month to 39. 450 deductible

Fairwind profile image
Fairwind

See if you can get into your states Medicaid Program..A different deal than Medicare..

how old are u? my medicare pays most and my supplement pays some and depending on the treatment there are foundations who do pay some its left up to your pharmacy to find that out for u dude

charlie

Doug47 profile image
Doug47 in reply to charlesmeyers1964

I’m 47, too young for Medicare I think. I still work and for now I have good insurance. 0 co pay for my meds.

in reply to Doug47

You are not to young to get disability, Medicare or Medicaid... not a dream come true for anyone but a safety net when neeeded!

larry_dammit profile image
larry_dammit

Like they say, apply for a discount or free med program with the med manufacturers, we did this for my dad. He and mom are on SS and are low income, they just got a years worth of there med for free from Johnson and Johnson. I didn’t qualify when I worked but May after we file our income tax this year. 🙏🙏🙏. Good luck to you

Have your doctor check with Patient Access Network. They can provide assistance if you qualify.

Raymonda100 profile image
Raymonda100

What state are you in? Why did you lose Medicaid eligibility? If you have no savings over $2000 in most states and income within the eligibility guidelines, which Is determined after deducting medical expenses, then you should meet the criteria. SSDI will not get you Medicare right away. The hospital’s social service department should look into getting you back on Medicaid.

Tekton profile image
Tekton in reply to Raymonda100

Hi Ray

You might be responding to me? I lost my Medicaid because I went back to work and make more than $1,065 per month.

Seems like all of this is a catch 22. I make enough to not qualify for help but not enough to pay my bills.

Going to have to really hunt for assistance getting meds and tests paid for.

Kimmilemo profile image
Kimmilemo in reply to Tekton

You should be able to get the marketplace Obamacare .

Tekton profile image
Tekton in reply to Kimmilemo

That's my expectation or at least hope.

Kimmilemo profile image
Kimmilemo in reply to Tekton

Sign up start in Nov for a Jan 1 start date. where do you live? If you lost your insurance you can qualify for a special circumstance and get in now.

Tekton profile image
Tekton in reply to Kimmilemo

I didn't know that was a possibility I'll have to check. I live in Washington State

Kimmilemo profile image
Kimmilemo in reply to Tekton

If you lost coverage or going to loose coverage you can go on the website and apply now. There is a time frame of applying if you have lost coverage. Healthcare.gov

Doug47 profile image
Doug47 in reply to Raymonda100

I’m not on Medicaid, I have insurance through my work. They pay 90% and I’m liable for 10%!

I live in Wa state.

in reply to Raymonda100

I thought it’s based not on savings or assets owned, but solely on income?

Raymonda100 profile image
Raymonda100 in reply to

Medicaid has both an asset and an income test. Most states limit assets to $2,000 (not counting house/car). Some states, like NY, allow higher assets. Income eligibility varies by state, in large part depending on whether or not the state expanded eligibility as allowed by the Affordable Care Act (Obamacare).

kff.org/medicaid/fact-sheet...

medicaid.gov/medicaid/eligi...

policygenius.com/blog/a-sta...

in reply to Raymonda100

Not counting house and car is good..

j-o-h-n profile image
j-o-h-n

Thank goodness I embezzled when I was young.

Good Luck and Good Health.

j-o-h-n Sunday 09/30/2018 6:47 PM EDT

in reply to j-o-h-n

Hahahaha! Wish I had now!

j-o-h-n profile image
j-o-h-n in reply to

Never too late if you look good in stripes or orange jump suits....

Good Luck and Good Health.

j-o-h-n Monday 10/01/2018 9:29 PM EDT

in reply to j-o-h-n

We should be able to establish a well staffed band of misfits with little to lose. I don’t steal but maybe some other form of lucrative risky business could be at hand.. Let me know if you find a niche for a scallywag like me? No violence..white collor preferred? Those dammed international cyber criminals are raking in billions.. don’t think that they’re funding any cancer charities..

j-o-h-n profile image
j-o-h-n in reply to

Well maybe the same business that my parents were in... the iron and steel business. My mother used to iron and my father used to steal....

Good Luck and Good Health.

j-o-h-n Monday 10/01/2018 9:51 PM EDT

j-o-h-n profile image
j-o-h-n in reply to j-o-h-n

How about a polka dot or stripe spray paint business?

Good Luck and Good Health.

j-o-h-n Monday 10/01/2018 9:57 PM EDT

billyboy3 profile image
billyboy3

This is an area that we all should focus upon. I believe that if we got organized and presented a unified front, we could set up drug discounts with the various drug man. After all, they use In their drug trials in order to make the big bucks, so I think they owe us to help those who cannot afford their drugs.

It is a damned disgrace that we have men who cannot get the meds they need, without having to go thru the stress that comes from not being rich. total BS boys!!!!

How about some action in this area Daryl and others????

Doug47 profile image
Doug47 in reply to billyboy3

Good damn point! The pharmaceutical industry is a double edge sword! I’m learning how much all this stuff cost and it blows my mind! The eligibility for us should be at least reduce drastically since we are the test subjects of their fortunes!!!!!

Tekton profile image
Tekton in reply to billyboy3

I agree! It seems totally absurd that we pay for drugs they are testing on us.

I think we have gotten to far from taking care of those that need help. Insurance was started to share the burden amongst many so a few were not destroyed. Remember? There was a star trek movie Spock said something like this the one can sacrifice himself for the needs of the many. Next movie Kirk said something to the effect of the many can sacrifice themselves for the one.

I'm not even a trekie so don't make fun of me LOL

in reply to Tekton

You won’t pay for a test drug or the testing while on the test.

Tekton profile image
Tekton in reply to

Thank you, i have so much to learn

Doug47 profile image
Doug47 in reply to Tekton

Lmao, you are on it sir! Thank all of you for your information on this scary condition. I’m still working on the translations you all put out about this condition. Man, I’ve got a ways to go.

check with your state rep check with your pt advocate and see what options are available u have to check and see go on line put your problem thru google and the state there might be help u have to look

billyboy3 profile image
billyboy3

The point I was making is that one should NOT have to go through this, given that We, who are and have given our lives to assist the drug firms in both creating, then selling these drugs, have NO say in what happens, ie the sad fact is that we, once the drug trial is over, or for all of the rest, do NOT get a discount. Further, certain drugs of this type should be exploitable by anyone to the deteriment to those in need.

In other words, the rape and pillage of men with PC has to stop, Lupron does not cost $1,200 a shot to make boys, try about $57.

Time for action!!

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