Medicare

[Amore55]

Today allen5280 mentioned that he got approved for a new medication while on Medicare. I am very curious and have wondered is there anyone else on Medicare , for which I qualify, who is on good ms DMTs? I didn't know that Medicare would ever cover anything. Thanks for the help. Kelly

[Fancy1959]

Hello Amore55, it's Fancy1959 and i don't qualify for Medicare until June 1st but I just wanted to see how you were doing. How is your pain level? I've missed talking to and it worried me when you became so inactive in the chat room. If you just touch base with the chat room once a month, I would be assured you are doing okay. If you need someone to talk to, you know where to find me. Until we speak again take care of yourself. Remember together we are stronger!

[jennie62]

Next month I'm starting Medicare. Funny I used to teach seniors everything they should know about Medicare. Sadly I've remembered nothing from those days-then again healthcare and Medicare change yearly so I'm not really going to worry until...WHO AM I KIDDING...I'M WORRIED! I've never been on Medicare before and I'm not 65 yet. Can anyone tell me what to expect?

I called Medicare last week about the Medicare Savings Program and was told I needed to call the NY State Healthcare line. Grrr?

[Morllyn in reply to jennie62]

I am on Medicare but I got it when they gave me SS Disability. I also have medical insurance from the company I used to work for. Medicare is primary, so they decide what a doctor, test, etc. is really worth, after they get the bill and pay 80% of that figure. My other insurance, which is considered a secondary insurance, then pays 80% of the 20% that is left (unless the 20% that is left is a very small amount) then I pay the rest. My company insurance pays for my medicines and I pay only a small amount.

I believe when I turn 65, in about 4 years, and go on retirement instead of disability from my employer and Medicare, all of the above changes. I have no idea how it works then.

[AngieRowe]

Medicare does pay for several MS drugs. You need to do homework and see if yours are covered. There is a lot of difference in plans. That said, I found Part D that pays for copaxone and Ampyra. I also checked that it covers Tecfideria which is one my doc has looked as next. Medicare part D that I looked at covers more drug choices than my Blue Cross.

I will not be 65 until July. I am on Medicare A & B & personal insurance now, Personal is threw Ombama Care and cost $800 month.

I am now on copaxone and pay nothing, insurance pays + shared solutions. I have a two month trial for Amprya now but when script covers my insure + Ampyra will cover.

But when I go on Part D, Shared Solutions & Ampyra & all other expensive drugs will not be able to just write off differences. This is because Medicare does not allow. So with part D, my drugs will put me in donut hole in first month. Long story short. I will end up paying about $3,000 for first 2 months and then 450-500 month after.

My plan was to keep the $800 Obamacare as secondary so my drugs would be paid as I had met deductibles. But that does not work either because Shared Solutions & Ampyra does not pay the % they do not continue the grants sane as now. They do have plans but income rules and they are harder to get.

So the story is that we are damned to pay 20% of drug cost.

I'm not sure if we are required to take part D and Medicare supplement when 65. If I didn't get penalized I would keep the $800 but then we don't know what is going to happen to Obamacare.

[heidilegs]

80 20

[Momjules]

Good morning!

I am 55 years old and I'm on Medicare. Part a, part b, part d, and aarp insurance.

I was on copaxone for three years and since October 2016 I'm on tecfidera. I pay nothing for these drugs. There are foundations that will help you. My mail order pharmacy will help you apply to these foundations.

[Kath55 in reply to Momjules]

Momjules, I started on Medicare this month. I have called all sorts of foundations for my Gilenya and told NO funds available or we make too much money. Is th AARP helping you or is it like an insurance?

My insurance wants like25% of drug cost, which would make me pay about $1800.00 . I am going to have to stop treatments. I just wanna cry.

[Momjules]

Kath55: my foundation is called the patient access network foundation.

The drug companies should be able to help you. They have access to all the different foundations. They run out of money all the time but my pharmacy helps to find more.

Pan foundation phone number is 1-800-675-8416

Good luck!

[bxrmom]

I have Medicare after being declared disabled. I had to wait 2 years to get but luckily I was able to keep my insurance through my job at the time. The plan I have, CVS Caremark, approved my Tectifera a few days after I saw my Neuro who okayed it. I do not have to pay anything, which I think may because I have met my deductible for the year. I also get extra help from the state paying for my medications because of how much my income is from SSD. Otherwise I pay a small amount in the first few months until my deductible is met.

Jessie

[jennie62]

I can only hope the small amount I get from SSD and my meds being covered will make me just as lucky as you bxrmom !

Took me forever before SS would even think about putting me on disability, but once I had a "doctor's note" about having Primary Progressive/Relapsing MS it only took SS a short time before I received my Medicare card. Just a bit worried about how much my deductible will be.

Good luck to all!

[Allen5280]

Amore55 Yes my Medicare has approved Ocrevus according to my rep from Roche. The only reason medicare is actually picking up all but 45.00 is because I was on Copaxone witch I had to obtain a grant to be able to take. The deductibles and co-pays are so high. The costs of meds and doctors has pushed me (as so many of us) into the catastrophic category with insurance. I owe so much to hospitals and doctors because of the way it's set up. It is a practical financial nightmare. I have managed by selling my house and my belongings to keep my pretty credit score I worked so very hard for. It won't be very long until that's destroyed as well. Medicare can be a virtual nightmare to try and navigate. I was actually quite surprised by the call I received telling me it was in fact approved and will continue to be sceptical until it is actually taken care of. I hope you can find a way as well.