Insurance questions

[Gradyboy]

I am currently in treatment for CLL with Gazyva and Venclexta. I just was looking at my explanation of benefits and it looks like my copay for the Venclexta would be over $4000 per month. I am currently getting copay assistance from the manufacture, but my question is what happens when you are on Medicare in the US? If I relapse and on Medicare at the time do they cover any of these treatments? Does anyone mind saying what their copay for their meds is? I could never afford to pay thousands a month for meds. What do you do? I am 61 and still covered in my employers plan but I would like to retire someday. How do you navigate these cost? Now I am having a whole new panic attack.

[AussieNeil]

Did you mean to post in this community? Per the box above, this community is not currently active, and you'll be much more likely to receive a reply if you post in the CLLSA Community, of which you are also a member.

Neil

[Gradyboy in reply to AussieNeil]

Thank you. I still get confused navigating.

[AussieNeil in reply to Gradyboy]

If you decide not to follow a community and simplify navigation, just select the 'Leave' box, which you'll find below the community banner, when you aren't following Newsfeed or in the Chat screens. You can check back later to see if you wish to rejoin.

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[MyCLLJourney]

When I had to select my supplemental insurance for Medicare, I was told it would be very expensive for Calquence. The first month would be 5,000. Then you hit the donut hole and continue to pay a high price for the rest of the year. I don't recall that amount, but I recall it being over 10,000 a year.

Even when the limit on prescriptions of $2,000 starting in 2025 occurs (because of the affordable care act) I read there are loopholes that the drug companies will likely use to get around the limit. For example, changing the formulary just a little bit they can start their patent from the start again. Drugs that have a patent less than 9 years old are exempt from the limit.