Does Medicare d help pay for zyritga
Z: Does Medicare d help pay for zyritga - Advanced Prostate...
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Collarpurple
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Depends on what carrier you have. You can also contact Jannson Dupport Solutions and the Patient Access Network to help with the cost of zytiga. Usually your Uro should be the one to set this up.
Thanks we have united healthcare pwrferred
Sounds like you have a Medicare Advantage plan administered by UHC for Medicare.. Your plan will have drug coverage but there may be co-pays. By this time I hope you are being treated by a Medical Oncologist and not a Urologist..If you need help with the co-pays, their office staff can set that up or the pharmacist at the "Special Pharmacy" that will dispense the pills..There are lots of angles here..One angle is that Zytiga is now available as a generic at greatly reduced cost..UHC may insist that you use the generic..
Yes we already saw oncologist at Stanford and now we’ll see oncologist that was at Stanford and now is it Pacific Cancer Center they both said chemo
Medicare is not the technical name for the Prescription Drug Plan that is referred to as Part D. It is complicated and requires due diligence to understand. There is a coverage gap after your plan has spent $3820 on covered drugs. Once you reach the coverage gap you are responsible for the next $5100 unless you qualify for assistance if you are under certain income levels. In 2019 the limit for income (i think it is adjusted gross income). I believe the number for 2019 is about $84,000 for a 2 person household. If you don't qualify for financial assistance from the pharmaceutical maker or other philanthropic organizations, once you pass the "donut hole" you are responsibel for 5% of the cost of zytiga. Generic Zytiga is very expensive. These are significant numbers involved. Don't take my word for it. I suggest you call customer service for your prescription drug plan and ask them to review all of your options. In my case the hospital is $9331 per month and CVS is $4486 per month. The "donut hole" is the same no matter what happens. I also think there is a monthly limit of 25% of the monthly cost towards the donut hole. The told me the numbers and I couldn't figure out why the donut hole payment in the first month wasn't hired. I play with numbers and figure out that there is a cap on the payment so that they will collect the donut hole $ from me in 2 months.
As Magnus says the plan matters for what the copay is and what happens after the copay.
When you go through life, let this be your goal... keep your eye on the donut and not on the hole.
Good Luck, Good Health and Good Humor.
j-o-h-n Friday 05/31/2019 5:40 PM DST
Loved those doughnut holes as a kid. They were delicious. It was real hamburger, real pork chops, almost everything was real. Home made bread with real butter was to die for. Maybe I'm dying cause of that diet. But I would do it all over again.
Yes. In my case mHSPCa, they pay with an annual copay cost of $6500.
I would caution any High risk PCa patients about using an “advantage” supplemental Medicare plan because they limit you to a network which, in many cases, can preclude you from participating in a clinical trial which likely lies outside of your network.
You are right about the clinical trial issue. I went through hell to get an approval for an out of network visit to a trial operator..The good news, once you are a participant in a trial, Original Medicare takes over where necessary. This change occurred in 2011 when the big insurance companies wanted OUT of Clinical Trials and Medicare agreed to take over. Many people think that once you are in a trial, the trials sponsor pays for everything..Not true...
Yes heard that we have uhh preferred plan
That advantage plan limits you so far our Medicare plan f has covered all
I have Medicare Part D through one of United HealthCare's many "AARP Rx" plans. First month of Zytiga (1000 mg/day) cost me ABOUT $2,500, which when combined with other less-expensive drugs I take, promptly drove me past the so-called doughnut hole. So now I pay $565 per month for my Zitiga, and UHC claims they pay $10,700 per month for my Zytiga.
Hope this helps.
Yes I believe we have same plan
Unless you have a supplement probably not, my dad is on it ,folks are on social security so couldn’t afford the price, we reached out to the manufacturer and managed to get his med free. Get in touch with them it’s not hard. Good luck
i am in a similar situation like Gearhead. Co-Pay in January for Erleada is about $2700 which puts me right into catastrophic coverage. Then my future monthly co-pays are about $597. Note that I am in standard Medicare with Plan D. One thing that I check every fall when renewal time comes around is to check next years formulary to see if all the expensive prostate cancer drugs are covered i.e. Zytiga, Extendi, Erleada
Thanks mpc for the tip about checking formulary. I started Zytiga this Jan, so I haven't been through a year's cycle yet. And since my other drugs are relatively inexpensive, I've never been motivated to learn exactly how Part D and the formulary works. So dumb question: Do all Part D plans have the same Medicare-mandated formulary, or do formularys vary plan-to-plan?
Yes Medicare covers it all
Have no idea to what you are referring when you are advising that medicare covers it all.... Individual is asking about coverage for Zytiga which many Part D plans DO cover but the copays are still quite substantial.... If one is not well set fiscally this can take a HUGE chunk out of daily living expenses.... Best to explore Prescription assistance programs as advised by others in response to this post.
Here in Australia
We have Medicare for every person
We can also choose to be insured
But regardless if you meet criteria it is. Covered by Medicare
Keep forgetting that everyone on this list is NOT from the USA.... thanks for the clarification.... BTW... If you choose a private insurer is your medicare still active as well??
We are a very lucky country and still they whinge
Every person pays a Medicare levy
It’s automatic from our wages
Some choose to pay for private insurance as do we
But really it’s not worth it I’ve decided
Basically you get to choose your own Dr
No waiting lists for surgery and very little else
But so far my husband has only used the fund to have robotic biopsy
We have both cut our hours down dramatically for work
He just isn’t up to it but pushes himself to do half days I am a registered nurse and we basically came home here to the country to care for my 84 year old mum on the farm
But Medicare pays for all his cancer drugs all Drs visits
All chemo
I read this site and feel sad that all of you have to find money
This is your life we are talking about
Govts upset me badly !!!
Having Gov't insurance to pay for my medication would be a HUGE help... when/If I get to the point of needing meds that do NOT need to be administered by an MD ( in which case it would have to be paid for by my Part D medicare insurance) the copays will bankrupt me..... who the hell needs THESE kinds of worries when you are already worrying about your life... it becomes a full time preoccupation....staying alive.... AND they won't let you even choose NOT to participate.... I , for one, would sooner bow out gently than face what my remaining years promise me but this is not an option.... I have suicide ( a very unpredictable option) or waiting until I am @ 6 months away from death when I can go to a state that allows Euthanasia..... big help!!! Getting older sucks....getting older with cancer sucks that much more.
I agree I hate cancer😫 I saw you are single I hope you have family or friends to talk too. I would take this cancer in a sec instead of hubby I hate and my heart breaks for every man that has this
I hate every time I read the profile and it says single man I just pray Every single one has people that love them. Because to me because you’re all my heroes and even though I hate this site I feel honored to have met you all
Even if you have lots of support it comes down to just the 2 of you. But know every wife or partner is praying for peace
And that this horrible disease will
Leave every man here. When you feel
Alone remember even though we may never meet all of us will be here for you
You’ve made my day
I start the day reading these very real very raw stories.
I salute you all
I salute your partners and your children
Travel well x
It’s the worst feeling that this horrible disease will take our other half. All dreams start to fade and you get soo angry
You were suppose to grow old together and enjoy life
But that door got slammed in your face you scream cry
Throw up and just want to die but then you read all post
From the men that fight this You said yourself Toughen upFor every day that He is here I will be grateful and I will try not to think of the future as hard as sometimes it is I’m so sorry your husband’s going through this and so are you Sharon
Just got our cost for Zytiga 2,767 $$$
From our drug Specialist at cancer center said she found money in a foundation hope we Qualify
