Has anyone on Medicare ( or Medicare Advantage)gotten financial assistance from Orgovyx manufacturer?

[PBnative]

I’m going to get my doctor to help me apply since co- payment assistance isn’t available if one is on Medicare . Co-pay is 500 on United Healthcare Medicare Advantage .

[maley2711]

I think if you look carefully at Orgovyx website, you'll see what is needed in order to qualify. If you are happy with United plan in all other ways, I suppose you wouldn't want to change...but perhaps cancer patients have no option to change because of our pre-existing condition? In that way, Obamacare is a fairer program. For insurers, I suppose they prefer the Medicare design? If you check GoodRX and plug in the drug, you will find lower copays if contracted with some other plans...at least what I found for plans offered in our area. I think Kaiser Advantage approx $300/mo.

I've been wondering if other covered ADT drugs like lupron cost the government less in subsidy...if not, why not offer the same deal for Orgovyx. Maybe older drugs are generic by now.

Hope you have good luck with the application!!

[rmarkley in reply to maley2711]

I have been on Orgovyx since July 2021. (Transitioned from Firmagon.) Note that the Orgovyx website has a place where you can sign up for the first 2 months at no cost to you. All they need is your MO prescription. After the first 2 months, the prescription is filled by Biologics in Cary, NC. Your MO will need to send the prescription to them.I am not charged anything for my Orgovyx. I am on an Anthem Medicare Preferred (PPO) policy.

When I started Abiraterone, I balked a little at the $85 copay. The specialized pharmacy put me in contact with an outfit called The Assistance Fund. As long as your income is below a fairly high level, they cover the copay. Minimal paperwork, and abi comes with no fee attached.

When I started Orgovyx, I told Biologics that I was on the Assistance Fund program. They handled everything, and I get my Orgovyx at no charge.

The fees are probably a function of your insurance, but a call to Biologics might be useful.

[6357axbz in reply to rmarkley]

Is Anthem Medicare Preferred (PPO) a Medicare Advantage plan or is it a Medicare supplement plan? Do you have a separate Perscription RX plan?

[rmarkley in reply to 6357axbz]

It is a Medicare Advantage plan. I have never dealt with a separate prescription plan. I have Medicare Part A and Part B plans

[6357axbz in reply to rmarkley]

Thanks!

[maley2711 in reply to rmarkley]

thanks!!

[PBnative in reply to rmarkley]

I may qualify for Orgovyx free after searching the website as you suggested . Thanks . Next step - get the Zytiga covered !

[rmarkley in reply to PBnative]

The Assistance Fund covered my abi from the start. In fact it took a couple of months to get set up, so I had to use my $85 Tier 4 copay a couple of times. Once everything was set up, they even reimbursed for my own out of pocket copays. Contact The Assistance Fund. They are easy to work with.

[PBnative in reply to rmarkley]

Will do … thanks 🙏🏻