I should be shifting over to Medicare in Dec. but haven't called Genentech yet. I remember them asking me if I had employer insurance or government during the conversation about financial support.
So...I'm wondering if they also have programs to defray the costs of Ocrevus for people on Medicare?
I am on Medicare as my primary and Medicade as my secondary. All my medical expenses for me to the point of Medicare "extra help" which is Medicaid.
So are you saying that you don't need a financial support program from Genentech because your infusion is covered by Medicare and Medicade??
I'm just in the process of figuring out Medicare and whether I need a supplemental plan or should I go for a Medicare advantage plan. Medicade is not part of my picture.
I shouldn't have to cause that's the extra help, they paid for it last year
I was Medicare and suplimentals until all the copays and deductables (which I'm still paying on) exhausted all my resources. Then I had to apply for Medicare "extra help" and that is through the State and here it's Medicaid with a fancy name of Sooner Care. It's like pulling teeth to get them to pay their part. Well last year waas my first on it, think mid July. They paid everything without any issues. This year their trying to deny everything. My Ocrevus infusion in June still hasn't been paid. I got a letter 3 weeks following my infusion that my pre-approval for octopus was denied due to not being medically necessary. I talked to my infusion center today and they reassured me imwouldnt be responsible and their going to keep trying to fight it. Even if it fails they will not charge me. According to my Medicare statement that's 10,000 outstanding.
I don’t know about Ocrevus on Medicare but I know the funding from Aubagio quit when I went on Medicare. I got United Health and they only covered a portion and without help it was to expensive. So I had to look for grants and finally found one with funds available 👍. MS On One helped in locating it. I know a lot of the company manufactures help with commercial but not Medicare 😖. Do your research, get free help with this so you aren’t 🤷🏼♂️. Good luck 🙏👍🐾 Ken
I recall Genentech said they had another program for those on government insurance
call ocrevus directly, they will put you in touch with someone that can help you directly 1-844-627-3887, they will give you a case worker to help you navigate, they did me . Yes, once you go on medicare things change again! Also The assistance fund(TAF.com) will also help you if they have funding. I may have to call them again oncethe new year rolls over,insurance changes.I am on medicare with a secondary insurance bc/bs. good luck!
Thanks pamgarner !
Raingrrl Medicare is bare bones/basic. It is vital and necessary for those of us classified as seniors, but it is also a complex topic for patients to navigate and fully understand. For instance, in my case, discharged from rehab, unable to walk, Medicare will pay for OT/PT and nurse visits (so far only 1x week), but not for transportation to the surgeon for follow up, or for someone to help me bathe. As I am wobbly, compromised by a surgical boot, and live alone, getting into the shower is risky! Yesterday, I was able to lean over the sink while kneeling on the knee scooter (which Medicare does not pay for) and the OT washed my hair. But I have not had a shower since coming home 8 days ago because I have not been able to find a strong woman to help me get off the knee scooter, onto the bath chair, and hand me the hand spray. The bathroom is too small to accommodate a wheelchair; even with the knee scooter it is tight, so I must back in to reach the toilet and shower, positioning the unbroken limb in a way that I can reach my destination. I have contact with a private agency that may help hose me off, but I am still waiting to hear when someone might come. And though I will be so happy to be thoroughly clean, it will be the most expensive bath in my life! Thank god I have saved my money for just this sort of emergency. I am grateful that Medicare is provided, but stay informed and be aware that there is talk in Washington about reducing Medicare benefits further.
I have United Healthcare Medicare Advantage plan but I am blessed to be able to carry my prescription plan from my employer so it makes me eligible for copay help from Biogen the manufacturer of my Plegridy which would be $40 a month but they pickup the entire bill. It is truly a blessing. As many prescriptions as I have all assistance is appreciated.
Donnie
Raingrrl medicare is my primary and I have BC/BS from when I worked as my secondary. I have not had to pay money out of pocket for my Ocrevus treatments so far. I wish you luck!
I have traditional Medicare with a supplement from AARP through United Healthcare. I had my Rituxan infusions in August and everything was covered in full. I hope this helps and that you’re able to find a good plan that will work for you.
I am on Medicare. I have supplemental plan f thru aarp which uses United Health Care as the insurer. I pay nothing for my Ocrevus infusions because it is classified as an outpatient procedure not a prescription drug. I have had two infusions while Medicare with my third one next month.
Thank you RobertCalifornia ! That’s the kind of info I was hoping for.
I have a medicare advantage plan. i have had my first two pack dose and going the end of this month first full dose. Because I am considered low income and I do get medicare extra help for some costs, but still higher than average SSDI. Where I live and my health plan, the hospital will not accept the free drug from manufacturer I am eligible for , so they bill my medicare for the procedure, and then I am responsible for 20% cost of Ocrevus. With this still too expensive, I obtained a grant from a foundation that helps with cost of medications for MS, and the hospital bills the foundation secondary for full cost.. You can find these foundations at needymeds.com to see if you are eligible. As you possible realize, I was on the phone a lot about this. I hope that noone has to jump through these hoops to get answers. Good luck and be well
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