USA — Typical patient costs - CLL

[KLW4025]

How can I determine what my out-of-pocket treatment cost will be? Are treatment plans a package deal — all-inclusive or à la cart?

[Suzi_]

Your insurance should be able to answer that. U may need a code from your Dr first so insurance can estimate cost

[GMa27]

I paid nothing. Depends on ur insurance.

[Kw2020 in reply to GMa27]

What kind of insurance do you have GM?

[GMa27 in reply to Kw2020]

Up until last year I had Blue Cross PPO. All thru my 12 years of W&W and chemo. Now I graduated to Medicare with my secondary Aetna. Been very lucky so far with no costs. My prescription plan covers Ibrutinb if I ever needed it. That is thru Optum RX.

[Hidden]

depends on your treatment. If your using novel drugs they are a separate thing from the rest of your medical care. they would be billed under your prescription coverage.

[Mprm]

This issue was a major source of frustration for me before beginning treatment. The type of insurance you have will determine your out of pocket costs and it can be difficult to wrestle an actual cost to you from your insurance company without a doctor’s order for treatment. If you are on Medicare your part D drug coverage company should be the one to call for details.

[tryandtry]

KLW:

If you're now on Medicare, and have a decent medigap policy, there should be no cost. If you have one of the lower medigap plans, there may be some cost, but probably not too much (I honestly don't know, I have "Plan G" - it covers all).

Medicare Part D (Rx) insurance should cover your pills, like Imbruvica, but your co-share will be about $12,000/yr. However, there are many charities that will pick this, or part of it up, depending on your income.

If you need IV chemo, it will be covered 100% by Medicare, Part B.

Gary

[KLW4025]

Thank you. I have an Aetna Medicare Advantage Plan.