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.
Insurance questions: I am currently in... - CLL America Support
Insurance questions
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Gradyboy
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Neil
Thank you. I still get confused navigating.
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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.
