What do i do?

[Teddysuperstar]

What if you have been on imbruvika for one full year and all of a sudden your insurance wont pay for it because it costs 11,000 dollars a month. I have full medicaid and now im having trouble getting them to approve and authorize my script. Pills are sent with refills and medicaid wont pick it up. What shall i do? I havent the money.

[MsLockYourPosts Passed Volunteer]

Teddy - I would start by contacting LLS and asking what advice they have regarding your situation. You might need to talk to a regional office, but I would start with national. 1-800-955-4572

[migirlusa]

Teddy - Also talk to the specialty pharmacy they may know of services or grants that will help you. My pharmacy is in Flint, MI. They are extremely helpful. Best of luck.

Pam

[lankisterguy Volunteer]

Hi Teddy,

MsLYP and migirlusa are right on point. Start with LLS

-

you can also consider this route:

-

Your CLL expert doctor or staff will prescribe the Ibrutinib using one of these 4 specialty pharmacies: Avella, Biologics, Diplomat or ONCO360 and they will get approval from your insurance and send you the drugs by FedEx each month.

-

As long as your gross income is less than $80 to 89k per year, then that specialty pharmacy should also help you apply for copay assistance through one of these: rxassist.org/patients/res-c...

-

If the specialty pharmacy does not help, then contact the LLS and ask them to assist you

The Leukemia & Lymphoma Society

lls.org/

800-955-4572

-

Dedicated to funding blood cancer research, education and patient services. Offers a variety of services, including an Information Resource Call Center, limited financial assistance and co-payment assistance (depends if funding is available), support groups and a patient matching program.

-

Programs that Assist with Medication Co-pays rxassist.org/patients/res-c...

-

Some organizations offer to help insured patients that are having difficulty paying the co-pays for their medications or their insurance. These programs are for very specific diseases or medications. Some of these programs include:

-

Caring Voice Coalition was established early in 2003 to serve comprehensive needs of all individuals affected by serious and chronic disorders, through collaborative efforts and partnerships with organizations established to serve those patient populations. Current programs include: Insurance Reimbursement and Advocacy, Vital Relief (need based financial assistance limited to certain disorders or medical conditions), Compassionate Care (counseling and counseling referrals) and Public Advocacy. Visit: caringvoice.org/

-

The Chronic Disease Fund, a non-profit organization founded in 2003. Its focus is to provide assistance to those under-insured patients who are diagnosed with chronic or life altering diseases that require the use of expensive, specialty therapeutics. Visit: cdfund.org

-

The HealthWell Foundation, a 501(c)(3) non-profit organization established in 2003 to address the needs of individuals who cannot afford their insurance copayments, premiums, coinsurance, or other out-of-pocket health care costs. Visit: healthwellfoundation.org

-

The National Marrow Patient Assistance Program and Financial Assistance Fund. The Marrow Foundation is the fund-raising partner of the National Marrow Donor Program (NMDP). Funds from this program help patients pay for searching the National Marrow Donor Program (NMDP) Registry and/or some post-transplant costs. Applications for Patient Assistance Program funds must be submitted by an NMDP transplant center. Eligible patients may ask their transplant center coordinator to apply for one or both programs. Call 1 [phone] or email [e-mail].

Visit: marrow.org/PATIENT/financia...

-

The Patient Access Network Foundation is a non-profit 501(c)(3) organization dedicated to supporting the needs of patients that cannot access the treatments they need due to out-of-pocket health care costs. Visit: patientaccessnetwork.org

The Patient Advocate Foundation, a national non-profit organization that seeks to safeguard patients through effective mediation assuring access to care, maintenance of employment and preservation of their financial stability. The Patient Advocate Foundation's Co-Pay Relief (CPR) Program provides direct co-payment assistance for pharmaceutical products to insured Americans who financially and medically qualify. The Program offers personal service to all patients through the use of CPR call counselors. Visit: copays.org

-

Patient Services Incorporated, developed in 1989, is a non-profit charitable organization primarily dedicated to subsidizing the high cost of health insurance premiums and pharmacy co-payments for persons with specific chronic illnesses and rare disorders. PSI is committed to assisting persons with chronic medical illnesses in accessing health insurance and pharmacy co-payment assistance. Families requiring assistance in maintaining the high cost of their health insurance premiums or co-payments are offered assistance based upon the severity of medical and financial need. PSI offers a "safety net" for persons who have expensive chronic illnesses and for those persons who "fall through the financial assistance cracks.

Visit: uneedpsi.org

-

Len