Co pay assistance exhausted for Jakafi

[Wewo01]

My BCBS coverage through my employer was changed at the new year. Someone decided I was too expensive and changed how drugs were covered. They used to apply toward my deductible and then covered 100%. At the beginning of this year that changed. Drugs no longer factor into the deductible and I have a copay for all meds which is fine except the copay for Jakafi is $5108 per month. So, some advocate with my employer enrolled me in IncyteCares for copay assistance which they applied in November and December! My BCBS would have paid 100% then. Now, as of February 20, my copay assistance had maxed out and I am SOL! Are there any other assistance programs for Jakafi out there!

TIA!

Kim

[hunter5582]

Sorry to hear about the problems with insurance coverage. It is truly dreadful to have an insurance plan with no out-of-pocket cap for medications. This amounts to a denial of potentially life-saving care.

I would start by going back to Incyte Cares if you have not had direct contact with them. If that does not work then there are other resources available.

The PAN Foundation is a good place to start. panfoundation.org/

Wishing you success moving forward.

[Chicagopv]

Ask Incyte if there is any other help. Maybe also the Leukemia and Lymphoma Society. I’m so sorry for your situation. My husband’s insurance paid for my Jakafi until I turned 65. On Medicare I’ve had to pay a few months until I got out of the donut hole. this year Jakafi was free after the first month, thanks to Biden legislation.

[Wewo01 in reply to Chicagopv]

May I ask what plan D you have and how much do you have to pay in the donut hole? And THANKS so much for responding. I am about to enroll in Medicare.

[EPguy in reply to Wewo01]

Same here, I'm about to enroll. The donut hole is history starting this year.

The max for drugs in 2024 is $3250. In 2025 and later it is 2000. Unanswered right now is whether the $3250 will apply for just part of 2024, likely so. So for me it will be 3250 in May 2024, then annual $2000 every Jan.

My understanding is once the 2000 (or 3250) is paid any other meds are zero cost, so if you have something that is say $50 per Rx that goes away.

My plan is to get a zero premium drug plan with part G, since we max out the limit ($2000 in 2025) I find no advantage in paying any premium for a drug plan.

I may also have reason next couple years to learn about high cost meds off-label in this new system.

--

All the above assumes one does not have a generous gov't retirement benefit or the like.

[artandcats]

please contact the PAN foundation online, or you can call. They paid all me Jakafi copays for the entire 10 years I was on it. They are wonderful. Sometimes there is a waitlist, but mostly not. Have to reapply every year-/they are the best.

[Wewo01 in reply to artandcats]

Thank you! I will definitely check it out, asap!

[Chicagopv]

I have AARP MedicareRx preferred (PDP)and AARP Medicare Supplement Plan G., both UnitedHealthcare. You can go online and list your meds and see which plans are best. This year I think that after you spend $2000 on meds, everything’s free. I did have to pay for one medicine that’s not covered, but it wasn’t much. My local CVS offers a free Medicare consultant, which I haven’t used.