Aetna finally approved Ocrevus after an appeal. Their reasons for denying it in the first place were stupid but that's kind of how it goes. But...because it took so long, I had to have another dose of Tysabri starting the 12 week counter all over again. I'm scheduled to get the first half dose Dec. 8th.
I first have to make sure I have the financial support in place since I'm not anywhere close to be able to pay for it on my own. Anyone have any difficulties getting financial support from Genentech??
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Raingrrl
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My insurance (Blue Cross) approved within 24 hours and covered 100%. There is an Ocrevus Facebook group with over 4,000 members, and judging by comments there it seems most everyone who requests help from Genentech gets it. Most end up paying very little, if anything. If you haven’t met your deductible and out of pocket, insurance may not cover as much (depends on individual policy), but people are having success getting Genentech to pay the balance. Best of luck, and let us know how things go.
Hi @erash... I haven't talked to them yet. I thought they might contact me because Biogen had reached out to me when I first started Tysabri. So...I'm just going to call them.
Raingrrl So glad that you got the Aetna approval! If only these insurance companies would understand that the stress they put us under worsens our disease and costs them more money!
Thanks @Yooper. Hadn't heard of the Assistance Fund. I haven't had too much trouble getting assitance from Biogen for Tysabri and my income is even less now. Just don't have any experience with Genentech.
My wife and I are snowbirds. We spend the winter in Florida. We are between Tampa and Orlando off the I-4 corridor. I started using the a fund while living in Wisconsin and doing Copaxone.
Raingrrl I hope that the company will help you with the cost of the medication. I know a lot of the different drug companies have assistance programs with cost of the meds. Please keep us updated when you can.
I had no difficulty with Genentech getting copay assistance. I only had to cover my remaining medical insurance deductible. Genetech has been the most efficient and consumer friendly group I have dealt with in years. I went thru Genetech Access Solutions. Website is Genentech-access.com. The website is pretty self explanatory and there is a phone number to call for help. The first time I tried to register I used my iPad. The website did not work with Apple products. This was early in April as my neurologist prescribed it for me right away. She was the first in California todo sn Ocrevus infusion (according to a Genentech rep I met at an MS walk).
Hi Wnmaddox123 ...I was on Copaxone first for about 13 years When it stopped working, I was switched to Tysabri. Stayed on Tysabri for 5 years despite being JCV+. I’ve now been on Ocrevus for 2 years. My insurance at the time approved it when my neuro appealed the original denial. There are some drugs I cannot take because of the PML risk or other disqualifying issues. There weren’t as many options even 2 years ago.
Oh you give me so much hope . I’m positive they will deny it but maybe we will win the appeal. Occrevus says that if my doctor is appealing the denial I can get the medicine free- but not sure what I’ll do to pay for the costs of the infusion services/ nurses. How you feeling on occrevus?
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