On original Medicare and satisfied with it but have no prescription coverage. He is now going on Nubeqa and it's expensive. What do you have that pays for cancer meds? Looking at supplements but don't think they include meds. Had plan D in the past and it covered nothing except cheap generics at that time and what I'm reading is they can stop covering certain meds at any time during your time with them. Know nothing about medicare advantage except MDA does not accept it. Only have a few days left to change or add to. All help appreciated and since I'm 77, please be as specific as possible. At this point, my brain is fried! Thanks
Ins. help please: On original Medicare... - Advanced Prostate...
Ins. help please
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Pops78
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54 Replies
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He will have to pay a fine for dropping part D, but he can go back on it. It's going to be expensive. Go on the Medicare website. You can enter the drugs you are on and see what's available.
Otherwise, you may have to order your drugs from India.
That's the one thing about having a service connected disabled really helps with. VA picks up my meds and treatments....over $27,000 in Aug.
Never heard of ordering them from India but that's most likely where they come from anyway. Any experience with that?
I can send you information on that through the forum chat function.
Please do and thanks, so appreciate it.
Contact a reputable medicare broker. I have bought drugs from a company in Canada and they ship from India. Now i just run to Mexico and buy things there
Would love to know more about that. Thanks
So you live close to Mexico for that? Would like to know more about that? Can you order from Mexico?
I live about 3 hours from the border, we just park on US side walk across border to pharmacy which is a five minute walk, purchase our drugs and walk back across. Super safe and great prices. I typically go for inhalers ($3) and Z-pack antibiotics ($5) If friends need anything I pick it up for them. I usually buy about 25 inhalers and 5 Z-packs, they are great to have around for friends. Those prices are better than with my insurance and I can buy in bulk
Sounds great. We live further then that in TX but might have to make the trip. Don't know how safe it is with all the illegals on the Mexico side right now? What town in Mexico is the pharmacy? Wonder if I can contact them to make sure they have the med? Do you need prescriptions?
I use Purple Pharmacy in Mexico, don't think they have locations near TX border but you can check prices on their website
I'll look it up for you. I'm a broker.
The prescribed drug, Nubeqa is going to cost you $3,031 in January and then $610 per month thereafter. I'm in Ohio. What is you zip code? The pricing could be different in each state. You can call Nubeqa if you can't afford this drug 1-800-288-8374. The website is really good. If you need help, please message me.
Zip code 77657. Is the monthly cost your stating being on a Plan D, a supplement or MA?
Part D with a supplement. I'll look up your zip
The AARP Medicare Rx Walgreens plan looks good. It has a 4 star rating. The Premium is 29.30 per month. the Drug cost would be $3,020.28 in January and then $634.61 per month thereafter.
Thank you for helping!
Does that include his penalty for previously dropping out or how does he learn that?
He probably needs to know there can be an income -related additional charge from SSA, too.
He will need to include the penalty of about 1% per month when he dropped out.
Is that 1% of the monthly premium cost? Not sure when we dropped it but it's probably been years so that could be costly and wonder if it's worth it if they don't cover many drugs?
What is an income-related additional chg from SSA?
Thanks for the help, I'll look at it
I am in same situation. The cost of Nubeqa with part D coverage is going to cost me about 10000.00 per year. If I do not get a grant or some other help my MO has suggested the possibility of switching to generic Zytiga which would reduce my cost to about 1200 per year....not sure if that is a good idea though.
Call Bayer to see if they can help you.
You can not get help from Bayer w/Nubeqa if you have Medicare. Only with regular insurance.
I don't think Zytiga is an option for us. His Onc. sent us a form so I'm filling it out and sending back for help from Nubeqa Pharma. Crossing my fingers!!
Thanks so much!
I'm not understanding the donut hole? Sounds like if we spend $3031 in Jan. with a $480 deductable, we are in the donut hole in the first month? And will pay around $2400 each month for the next 2 months til we reach $7050, then pay 5% of their cost the rest of the year. So instead of the drug being $9523.70, it's ends up being $12540.80? Is that right?
If one is enrolled in Medicare part A, part B and part D, one could get coverage for inpatient, outpatient and medicines expenses.
All these benefits are offered by Advantage Plans or F plans or other Medicare supplemental plan which include medicines.
He needs to go back to Medicare part D. Medicare part D is managed by insurance companies. CMS does not administer plan D, they discount a premium for part D from the pension when your are enrolled, but the medicines covered and the copayments depend on the insurance company managing Medicare part D.
medicare.gov/drug-coverage-...
Look for Medicare supplemental plans for your county or in the AARP web page.
I personally do not like Advantage plans since you have to do everything in their network to be covered. I have a PPO Medicare supplemental plan including medicines with Blue Cross. I am enrolled in Medicare part A, part B and part D.
Darolutamide (Nubeqa) cost around 13K a month.
The $13k/month is for someone without Part D? Others above have mentioned $600/mo with Part D?
Do the insurers negotiate for prices that are so much less than for someone who has no drug coverage? Surely the insurers aren't covering the difference between $13,000 and $600? That is a losing business model!!
The government helps subsidize Medicare Part D costs
I find medicare to be a nightmare get different answers everytime I call..Switched to Kaiser hopefully I will have a better experience
What is Kaiser?
It’s a Medical facility found in California hmo all is taken care of in one place…
I have been ordering drugs through a Canadian company called Drug Mart Direct...drugmartdirect.com 1-855-402-2022 toll free. I was given the contact by my US internist. They have unbeatable prices and outstanding customer service, mailed direct to your door. Good luck.
My hubby is on Nubeqa and we could use help with cost. He goes on Medicare 1-1-22 & his new Part D cost will be $2980 1st month then $669 each month after that. We went on the drugmartdirect.com site and it shows $12,109 for 3 months--so that would be $4,036 per month, that's way higher than his Part D will be. Are we doing something wrong or is it just that drug?
Get part D and depending on income try for a grantPan or Patient Assistance
I bought some drugs from cheapmedicineshop.com. It comes from India but it was very serious.
I have a part D plan and it’s been great, covers my meds. One of my meds, Xtandi has a patient assistance program that allows me to receive it at no cost and it’s not hard to qualify for it.I’ve heard to stay away from advantage plans, that they dictate what doctors you can see don’t allow you to go out of state for treatment and can stop covering a medication at any time. Also once you’re in an advantage plan I’m not sure you can change back to traditional Medicare during the next enrollment period, you’re locked into advantage plans.
For me traditional Medicare with a part D drug plan and a supplemental have been great.
Ed
I believe the problem with advantage plans is not the ability to go back on medicare, but that you can't then qualify for a supplemental plan to cover the 20% Medicare does not. This is especially true if you are not healthy. Medicare plus supplemental and D is the way to go. More expensive...but not in the long run. Advantage plans are great if you're healthy! And, if you're on this site...you're not.
• in reply toEdBar
We’ve had the same experience. His doctor just switched him to Jevtana. He’s on it every two weeks. I was shocked to see that it is being billed at about $60,000 for each session. So far we’ve paid nothing. Medicare and his supplemental insurance are picking it all up.
Try this organization. They are providing help paying for many prostate cancer drugs. Good luck and God bless
There are some non-insurance options. The Assistance Fund, TAF, can help with copays.Also, try Cancr.org. I will look for more.
Check with the available medicare plans and you will find many that pay a high majority of the cost. The the others I note will pick up the rest. Where do you live? Many states have an assistance program too. NY state has EPIC that, once the deductible is met drives copay to $10.00 message me for help.
Bayer offer the first month free. Message me. I have been on Nubeqa for 6 months now. psa 0.03
Do you mean "cancer.org" which is the American Cancer Society?
Just did a bit of googling. Search prostate cancer financial assistance and you will have many options.
What MVP?
mitral valve prolapse?
Good Luck, Good Health and Good Humor.
j-o-h-n Monday 12/06/2021 6:36 PM EST
The company name of my Medicare Advantage Plan is MVP
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