Any NY Residents on this Forum having EPIC pay for Expensive Drugs??

[Tommyj2]

hello.... will need to go on ADT soon ( unless I decide to forego the whole affair and see how long I live).... Have been wrestling with how to pay for any of the advanced oral drug treatments when the vast majority of grants are closed and Patient Assistance programs generally cover those on _ private_ insurance only... NY State EPIC is a possibility...wondering if any Medicare Part D subscribers here are from NY State and have EPIC paying for any of their expensive oral medications ( Zytiga in specific).....thanks much

[ctarleton]

No direct experience, but here's a starting point for EPIC "Highlights". You might be able to get some "ballpark" ideas about eligibility, fees, out-of-pocket costs, etc.

health.ny.gov/health_care/e...

Charles

[Tommyj2 in reply to ctarleton]

Thanks Charles.... actually I do medicare counseling and am quite familiar with EPIC... It's a very drawn out process to find out if they cover a given drug and was merely asking if anyone had already gone through this process.... I have EPIC and it saved me quite a few bucks before I found that I could do just as well with Blink Health for my particular Drugs...... It angers me NO END to see the prices being required for these life saving drugs that are simply out of reach to me..

[Magnus1964]

Try the Patient Assistance Network. If you are going on xtandi, call Xtandi Solutions. Your Urologist should be handling this.

[David20451]

PAN and PAF close and reopen regularly as funding sources open up to them. Keep trying.

[Bomberto]

Hey tommy....first remember...you won't be allowed to see how long you live so your best option there is to forget about that line of treatment....medicare will pick up the cost of adt provided your doc knows how to bill it...i have been taking the zoladex 10.5 subcutaneously for over a year...the hospital bills it out at well over 7500 . Then medicare beats it down to under 800 and the i pay 20 percent of that. That is pretty cheap in my book..this is thru medicare AB not D. In fact i do not have D...waste of money...

Also just gave up my supplemental plan that paid the 20 percent...those numbers did not jive either..what does jive is to stay alive....side effect of adt are tolerable...so grab 10 more years and go have some fun.

[Tommyj2 in reply to Bomberto]

Thanks for your thoughts on the subject B. I'm a bit more cautious about giving up a drug plan..... and planning on dropping my Medicare Advantage plan in favor of a supplement.. It's a crap shoot as to which way will cost less money but I have a LOT of consultations ahead of me and a slew of testing... Want my part B copays taken care of and the freedom to see whatever dr. I wish.... plus..for those of us whose bones have weakened...one trip to a Sub-Acute Rehab could empty ones bank account and I have NO money to play with.... If Prostate Ca alone were my only issue I'd be more inclined to play fast and loose but I don't want to have to worry about how much of a bill is going to come my way at this point.....already determined that I can't afford ANY of the oral meds that are not covered by grants or Patient Prescription Assistance programs ( not available generally to those of us who have medicare part D....so in that realm you are smart to not have it)... Bottom line.... there does not appear to be ONE best way to do things.... Recurrent Pca is a LOT more complicated to manage than the Tx decisions one must make when the friggen disease rears it's head initially