Deductible nightmare: Hi everybody, I... - My MSAA Community

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Deductible nightmare

Sandydemop profile image
61 Replies

Hi everybody, I could use some ideas from experienced people. I have a $4000 deductible on my new insurance and am running low on Copaxone. Does anyone know who can help? Copaxone cost $4000! Even with a $2500 gift from Copaxone. I still can't afford the $1500. Ideas please. Thanks in advance.

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Sandydemop
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61 Replies
Miriade profile image
Miriade

Hi Sandydemop. I always call the insurance to negociate the deductible in all my bills. They can pay the most part of your medication and your start to pay a fraction percentage of your deductible who can be split in months ahead. I have private insurance this year and it is working exactly this way. Before I had from my husband work and I also negociate all bills to be paid only small portion. We pay the insurance the entire year. Its always work for me and when I use to call for my husband bills without exception

laurenhc profile image
laurenhc in reply toMiriade

hi sandydemop, I went to Shared Solutions for my CoPaxone, which is paid for through AssistRx . My husband and do have a decent income, and they've always approved us for the assistance. You should call Shared Solutions. They're very helpful. The# is 1800-887-8100.

Sandydemop profile image
Sandydemop in reply tolaurenhc

Thanks Lauren, I will call them. Thanks for the number too.

laurenhc profile image
laurenhc in reply toSandydemop

No problem, Sandy. They've been a lifesaver for me, and that's something I'd definitely want to share with everyone! Good luck. )

Sandydemop profile image
Sandydemop in reply toSandydemop

Hi Lauren, happy ending to the story. Got the approval letter today from Shared solutions. Meds to be delivered weds.

Sandydemop profile image
Sandydemop in reply tolaurenhc

Hi, it worked!

Sandydemop profile image
Sandydemop in reply toMiriade

Hi Miriade, thanks for the idea. I had not thought to ask for their assistance. It is Obamacare (Affinity) so I don't know how flexible they can be but I will certainly try it. Great idea. thanks very much.

CrystalPenny profile image
CrystalPenny in reply toMiriade

I had that same problem but Axium Health care that I get my Copaxone from transferred me to a group who does grants and they pay for the Copaxone. Now I pay nothing. Who do you get your meds from? Do they have a company that does grants to help out?

Miriade profile image
Miriade in reply toCrystalPenny

I got full paid from Tecfidera for all the time I used, 2years

Miriade profile image
Miriade in reply toMiriade

But I always get great deals when I talk nicely with the health insurance to pay very little for MRI and other exames, breaking the premium in small amounts during the year in any exam I need. I use to call in advance and negociate before the business give to me the bill.

Sandydemop profile image
Sandydemop in reply toMiriade

It was hard for me to be patient. On hold over 2 hours altogether but I remembered what you said. Ty

Miriade profile image
Miriade in reply toSandydemop

Very happy for you. Always remember that they have many solutions depends of the clients and what they decide is flexible. Great!!!

Sandydemop profile image
Sandydemop in reply toMiriade

Hi MIriade, I called Shared Solutions yesterday and they want to evaluate my insurance (asked a million questions) to see what support I am eligible for. thanks though. I hope they will take into consideration I have been on copaxone for 6 years.

Miriade profile image
Miriade in reply toSandydemop

Talk with the customer service in "good stands and mood" and they will be more friendly to give to you the clues, the options and your solution. It is possible get your medication making agreement about your deductible or pay nothing. Remember that they are a big multinational pharmaceutical and Copaxone is on the top of the list for too many years and they "need"to help patients for other reasons. Just talk and you will get. Use more options like this Share Option, sending many papers and proof of whatever is only a formal way. Be friendly with your customer service to access more options😆

Sandydemop profile image
Sandydemop in reply toMiriade

Thanks. I will try it. I admit I was a little frustrated on the phone.

Sandydemop profile image
Sandydemop in reply toCrystalPenny

Hi Crystal, I get my Copaxone from Shared Solutions and CVS Caremark delivers it. I wonder if CVS has grants?

Sandydemop profile image
Sandydemop in reply toCrystalPenny

Hi Crystal, Shared solutions agreed to pay my deductible and for my medication. After much effort. Thanks.

Sandydemop profile image
Sandydemop in reply toMiriade

I was able to get approval from shared solutions. Thanks for offering your + experience.

Sandydemop profile image
Sandydemop in reply toSandydemop

Thanks 😊❗️

Iona60 profile image
Iona60

Sandydemop Are you on the 3x week Copaxone? When I was on it last year, the most you had to pay was $35. Have you been in touch with their Patient Assistance program?

Sandydemop profile image
Sandydemop in reply toIona60

Dear Iona60, I am on the 3x/week copax. They offered me $2500 toward the copay, and I believe they will charge me the $35 once I meet the deductible. I just have to find $1500. I will contact Patient assistance again. Thanks for your support.

Sandydemop profile image
Sandydemop in reply toIona60

Hi Iona60, Working on it. Submitted info. Should know by Tuesday the latest.

Iona60 profile image
Iona60 in reply toSandydemop

Sandydemop I was on Copaxone for 10 years. They had 2 programs. On one program they would ask for your tax return. If your adjusted gross income was below a certain limit, I think 50k, (they wouldn't say) there was no cost. On the other program, no tax return was required and your copay was $35. Each had to be renewed every year. They would send out forms in Oct or Nov. If I didn't receive them, I would always call.

Sandydemop profile image
Sandydemop in reply toIona60

Thanks. I'll find out next week

heidilegs profile image
heidilegs

Get a Mir that should take care of it good luck

Sandydemop profile image
Sandydemop in reply toheidilegs

Hi Heidi, Do you mean an Mri? And Thanks for responding.

heidilegs profile image
heidilegs in reply toSandydemop

Yes I did

Chris_Percival profile image
Chris_Percival

Just wondering, what does MSAA do? Where do all the donations go? Aren't they suppose to help people with MS? Also reading other replies, Shared Solutions probably will waive the deductible for you from past experience.

MSAA brings in millions of dollars a year. You think they should help with MS. Just saying. I have never heard from them even though. I have MS too!

Sandydemop profile image
Sandydemop in reply toChris_Percival

Hi Chris, Silly me, I did not call MSAA. Felt overwhelmed don't know who to talk to. But it is a good idea. I will certainly follow up with. Thanks!

Amore55 profile image
Amore55 in reply toSandydemop

Sandy, when I was on Copaxone years ago, Shared Solutions paid my entire deductible for me, $6000. If I were you I would call them again and basically throw yourself on their mercy for more help, believe me, they have the money. Just be honest about your situation. They have always been very generous with me and my husband has a very healthy income. Good luck and please let us know how it turns out, we all really care. Kelly

Sandydemop profile image
Sandydemop in reply toAmore55

Thanks Kelly, I will! I really don't want to go without the Copaxone and only have a few weeks left.

Sandydemop profile image
Sandydemop in reply toAmore55

thanks Kelly, Much appreciated. I am waiting to hear back from them Tuesday the latest they said.

MSAA_Staff profile image
MSAA_Staff in reply toSandydemop

Hi Sandydemop !

If you haven't already, please feel free to reach out to one of our Client Services Specialists for resources at our toll-free Helpline, (800) 532-7667, ext. 154, or you can email them directly at msquestions@mymsaa.org.

Take care!

Emily, from MSAA

WAshingtongirl profile image
WAshingtongirl in reply toChris_Percival

Chris_Percival , I hope this link works, and that it answers your questions about the MSAA.

support.mymsaa.org/site/Pag...

I'm really sorry you've had difficulty finding help with your MS needs. Perhaps someone at the number listed on the bottom of the link can further help you.

Sandydemop profile image
Sandydemop in reply toWAshingtongirl

Thanks Tutu

MSAA_Staff profile image
MSAA_Staff in reply toChris_Percival

Hi Chris_Percival !

MSAA provides free programs and services to the MS community, including: a toll-free Helpline, safety and mobility equipment, MRI funding, in-person educational programs throughout the United States, cooling vests and other accessories for heat-sensitive individuals, as well as other services like this community!

Thank you!

Emily, from MSAA

Sandydemop profile image
Sandydemop in reply toMSAA_Staff

Hi Emily, can you help me meet my deductible so I can get my medication renewed?

MSAA_Staff profile image
MSAA_Staff in reply toSandydemop

Hello Sandydemop ,

I would encourage you to reach out to our Client Services Specialists on our toll-free Helpline at (800) 532-7667, ext. 154 or via email at msquestions@mymsaa.org. One of the Client Services Specialists will be able to direct you to resources that may be able to assist you with getting your Copaxone.

Best of Luck,

Emily, from MSAA

Sandydemop profile image
Sandydemop in reply toMSAA_Staff

Thanks Emily, it worked out well. Very grateful.

MSAA_Staff profile image
MSAA_Staff in reply toSandydemop

Sandydemop ,

So happy to hear it worked out well!

Wishing you all the best,

Emily, from MSAA

Sandydemop profile image
Sandydemop in reply toChris_Percival

Hi Chris, I will call them early next week. Thanks.

Kenu profile image
Kenu in reply toChris_Percival

I was having 💰 problems also and had touched base with MS and advised their money had run out for help in August for Idaho. I am on Aubigo and called them and they setup a program to help. My insurance only pays 50 percent on MS drugs.

dogdaddy profile image
dogdaddy in reply toChris_Percival

MSAA paid for my last MRI because I have no insurance

Fancy1959 profile image
Fancy1959

Hello Sandydemop, it's Fancy1959 and since I don't remember speaking to you before I would like to officially welcome you to this amazing chat room. You have found a safe place full of the most caring and compassionate people I have ever met. Feel free to ask questions, voice concerns like you just did or simply speak to someone who truly understands what you are going through.

I went through a similar situation a couple weeks ago as my new neurologist order a baseline MRI of my head and neck. With my new insurance I had to come up with $1,600. That wasn't exactly in our budget either but it's less than half of what you're dealing with period what I worked out was I have the hospital except half the amount due up front and they agreed to Bill me monthly for the rest. It's not exactly a perfect solution since you have to pay too much money to a multimillion-dollar insurance company and Hospital but at least it gives you a chance to do the test and receive the drugs we all depend on.

Also, make an appointment to go see your neurologist. It can't hurt. They might have connections with the drug companies and pharmacies you have no idea of. I wish you the best of luck. Take care and please keep us informed. Remember, together we are stronger!

Sandydemop profile image
Sandydemop in reply toFancy1959

Thanks Fancy, I'm actually happily surprised at the amount of support and care I have received so far. Can't wait until Monday morning so I can actually try out everybody's ideas.

Sandydemop profile image
Sandydemop in reply toFancy1959

Hi Fancy, I got approved from Shared solutions for the deductible in full. I can get Meds next week.

Thanks for your support

lauranell2u profile image
lauranell2u

Call shared solutions. I had a zero copay when I was on it. They have awesome assistance programs.

Sandydemop profile image
Sandydemop in reply tolauranell2u

Thanks Laura

Sandydemop profile image
Sandydemop in reply tolauranell2u

Hi Laura, thanks for giving me hope. I got approved too.

lauranell2u profile image
lauranell2u in reply toSandydemop

Awesome!!!

Sandydemop profile image
Sandydemop

Thanks to all of you who have trudged this road and are willing to share your experience, strength and hope.

Jesmcd2 profile image
Jesmcd2CommunityAmbassador

Hi Sandydemop I haven't had the pleasure yet.☺ Hi and welcome to our MSAA Community ☺. How did you make out with your insurance situation? I'm hoping it worked out for you! If not, please let me know and l can give you a few more numbers that might help.

Jes🌠

~Helpful Hint~ If put an @ in front of person of who your addressing, they will be notified. IE @ jesmcd2 *With No Spaces*

Sandydemop profile image
Sandydemop in reply toJesmcd2

Hi Jes, I've been on hold with my insurance company for 61 minutes, no exaggeration. Funny it keeps saying "we'll be with you in a moment. Lol

Jesmcd2 profile image
Jesmcd2CommunityAmbassador in reply toSandydemop

I love how there say that! Good luck! Sandydemop

Jes 🌠

Sandydemop profile image
Sandydemop in reply toJesmcd2

Hi Jes, it was closer to 3 hours when all was said and done❗️

Jesmcd2 profile image
Jesmcd2CommunityAmbassador in reply toSandydemop

Sandydemop how are you doing? Are you getting things straightened out?

Jes🌠

Sandydemop profile image
Sandydemop in reply toJesmcd2

Yes, thanks Jes. On Friday I got approved by shared solutions for the entire deductible. Should be able to order Med's on Tuesday. Very grateful.

Jesmcd2 profile image
Jesmcd2CommunityAmbassador in reply toSandydemop

Sandydemop YEAH!!! 💥💥 I'm so happy that things worked out for you!

Jes 🌠

Sandydemop profile image
Sandydemop in reply toJesmcd2

Thanks so much! I'm very grateful.

Jesmcd2 profile image
Jesmcd2CommunityAmbassador in reply toSandydemop

Sandydemop how are you doing? Are you getting things straightened out?

Jes🌠

kdali profile image
kdali

Shared solutions “pays” my copay, I think it’s $1800

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