Does anyone know if Medicare Part D covers ven... - CLL Support

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Does anyone know if Medicare Part D covers venetoclax?

Lulu8581 profile image
8 Replies

Does medicare part D cover venetoclax?

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Lulu8581 profile image
Lulu8581
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8 Replies

several answers. yes it does. However you will have a large co-pay of about 12,000 dollars YEARLY.However since the drug is about 150,000 dollars thats a good deal. You might be able to get co-pay help from pan or leukemia society depending on your income.

Lulu8581 profile image
Lulu8581 in reply to

Thanks. Sounds like I wouldnt be on it for longer than a year so in the long run, what's $12k? (Eek!)

michaelmac profile image
michaelmac in reply to Lulu8581

For me ,,,, Medicare part D is extremely complicated. Let me point out before I start trying to help that,,,, you should double check everything that I say below

First of all ,,, Medicare part D is something that you buy. And lots, and lots, of people have opted for what is called an advantage plan. If that is what you have,,, you may find that the 12 K is not correct. In my case I have straight up Medicare provided by the government ,,,, there's still a charge. And as mentioned by IvotedforNixon it looks like the charge for either V or I is about $12,000. I have not taken it for a year so I'm not quite sure yet. There's all kinds of donut holes and catastrophic charges that apply. Like I said, to me very ,very complicated ,,,, and I expect/suspect that it's intentionally that way. And, as mentioned by IvotedforNixon you should look into assistance. On the other hand you might consider yourself fortunate, that your doctor did not pick Ibrutinib (as my doctor did) it's about the same price as V but you take it until it stops work. Some people have been taking it for years. So 12 K per year or so is for most of us a burden. BUT >>>12 K for 10 years ,,, $120,000 might break the bank. For that reason I strongly considered infusions which Medicare pays for ,,, although there've been talking about perhaps changing that. There also is been some talk about the new novel drugs being treated like infusions. I don't see that happening because it would be Uber expensive for the insurance companies.,,,, And ,,,the boys in DC (who have GREAT insurance ,,, that we pay for) usually go with the Insurance companies/lobbyists

Anyway ,,,the above is my take on the drugs and the insurance companies. You hear all the time about people choosing between their drugs and food,,,, which is just crazy. I wonder if we'll ever get our health system straightened out ,,, here in USA.

Remember,,,, check and double check what I have said, The above is just my understanding ,,,,I'm sure others have a different take on the mater.

Good luck to you and all with their treatments

Michael

cujoe profile image
cujoe in reply to michaelmac

Good Post, Michael!

in reply to michaelmac

most people on medicare part d never even reach the donut hole. but once your in the catastrophic part it's 5 percent with no cap on the co-pay AND the insurance company is the US government. the plan providers follow medicare part d rules. Part D was created before novel drugs existed. the congress is trying to pass a law capping medicare part d co-pays

skunkbay53 profile image
skunkbay53

Contact the PAN foundation. They give grants to help pay for many treatments

New1948 profile image
New1948

As has been posted many times, look for a trial.

tryandtry profile image
tryandtry

Go to medicare.gov & search for "Find drug coverage" (or something like that). It will give you VERY DETAILED AND EXACT numbers for each available Plan D in your state. As "I voted for Nixon" says, it's a very complicated variety of calculations, but the government makes it very simple for you.

Gary

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