Does anyone know if Medicare pays for the Gazyva infusions?
Medicare payments: Does anyone know if Medicare... - CLL Support
Medicare payments
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Hi AuntHelen,
I have had most of the new targeted therapies but not Gazyva yet. I rely on my CLL Expert and his Physician's Assistant who is fantastic dealing with insurance and Medicare.
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I trust you are referring to traditional Medicare Part A & B and I hope you don't have a Medicare "Advantage" plan = Part C.
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Since it is infused in a hospital or clinic, the cost will be under Medicare Part B. If you also have a Medicare supplement policy type F or G, then there should be no copay at all.
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Len
We have the original Medicare and the G supplement. Chose G because it takes care of the access fee to Mayo. Thank you for your response.
Medicare part B pays for cancer treatments that are infused in hospital, clinic, or drs. office.
Since you are under original Medicare- the hospital must advise you BEFORE treatment, if Medicare will NOT pay for any procedure or drugs given in the hospital.
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If they don't give you a written document and get you to sign an agreement to pay out of your own pocket, before the procedure, you will not be liable for the Medicare portion (80%) of the cost.
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Your G supplement usually pays the other 20% if Medicare pays.
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So make certain you don't sign any payment document, until you are certain what it covers.
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Len
does the g supplement cover regular prescriptions? Massachusrtts does not use these letter options. Just 2 core and supplement 1
No
Medicare part A & B and the (Medigap) supplement plans only cover doctors and hospitals (infusions in clinical settings and drugs professionally administered in the clinic or hospital). ( e.g.: Rituxan or Gazyva infusions plus their pre meds) ehealthinsurance.com/medica...
cms.gov/newsroom/fact-sheet...
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Prescription drugs taken at home (self administered) are Part D, those are separate commercial insurance policies and do have copays (e.g.: Ibrutinib/Imbruvica, Idelalisib/Zydelig, Venetoclax/Venclexta)
en.wikipedia.org/wiki/Medic...
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Len
Yes they do and PAN foundation
Medicare paid for all my Gazyva infusions.
Zeit