The Webinar is over 👍😊

[Kenu]

Those on Medicare, Medicaid, and supplement policies are save through this year and probably next year. Those thu supplement or ACA are also save thru this year. Right now the most affected by accumulating is Employee insurance thru the company or owners. The big places noted, Walmart, Home Depot, and other large companies. This Webinar will be posted in couple weeks to view so don’t get excited. This is mainly effecting you’re drug coverage, deductible, and out of pocket. There are free advocates in all states thru the insurance commission to call and help those effected. It is NOT the Drug Companies , it is insurances and owners of business that are implementing this. This is just my short survey of what was discussed. Ken 🐾🐾

[mrsmike]

Thanks for the info I was unable to attend.

[Fancy1959]

Dagon I forgot about it! I fell asleep and when I woke up my husband wasn't anywhere to be found. It kind of sent me in a panic when I spent an hour looking at for him and couldn't find him. I thought for sure he was laying out on the farm somewhere hurt and I couldn't help him. Turned out our rental house had a busted water pipe that finally thawed out and flooded the whole first floor of the house. Yuck. So he in my oldest son spent two hours mopping up the mess and trying to stem the flow of water in the house. You was a such a hurry to get to the house that he did not grab his phone on the way out the door so I had no way of reaching him. It's always something. I'll look forward to everybody's responses and see what I missed. Bummer. Fancy.

[erash]

My understanding per my husband who was wonderful enough to listen to the webinar while I was on another webinar:

It is related to prescription discounts that are deducted from your co-pay/annual deductibles that result in you taking longer to reach your annual deductible. Ex. You have a prescription that’s $100 and your co-pay is $25 but you have a discount coupon for $20. So rather than $25 going towards your deductible, only $5 goes toward your deductible. Hence, it takes you longer to meet your deductible.

Someone let me know if they have a different understanding of this.

Our insurance isn’t participating in this yet 👍

[Kenu in reply to erash]

The drug companies that are doing the help with co pays are starting to give out debit cards so the insurance companies can’t track it 👍. Sounds like the drug companies are on our side against the insurance companies 🙏😊 Ken 🐾🐾

[Iona60]

Do they think that this will apply to Medicare advantage plans? I'm hoping to get help for ocrevus from their foundation.

[Kenu in reply to Iona60]

No this is not effecting Medicare, Medicaid, or the supplement policies. Also not effecting ACA (Obama Care) either. There is some legislation in the works for this but sounds like couple years out and may never effect Medicare and Medicaid or supplement policies 🙏👍. Ken 🐾🐾

[Iona60 in reply to Kenu]

That is great news.

[Kenu]

This was more letting us know what is coming down the future. Insurance companies don’t like us getting the benefits from drug companies that offer help with co pays and don’t want that portion used towards deductible. Ken 🐾🐾

[erash]

I think big employers like Walmart or Home Depot. Said contact your HR to determine

[Kenu in reply to erash]

He did mention that is supposed to be written in your policies probably in small print somewhere? Ken 🐾🐾

[OKgal]

I'll look forward to when they post the replay of it. Had a crisis last night and was detained. I've been following this co-pay accumulator situation for a few years now. Another way some patients have been able to make it work is they pay for the medication with a credit card, submit the invoice to the pharmaceutical company for reimbursement. Whatever works, because the way it's working now is some patients are forgoing their medication due to inability to pay for it. Who knows how all this will shake out?

[Iona60 in reply to OKgal]

How does the insurance company even know? I have a credit card from ocrevus that is loaded with $20k. The infusion center keeps it and runs it through after the insurance company has paid.

[Kenu in reply to Iona60]

They say that they are unable to follow credit cards 💳 from drug companies as that is private and done after billing to insurance companies. Supposedly that is drug companies are doing this to go around insurance so it doesn’t go to drug deductible. The only ones being effected right now is large companies insurance program not other commercial policies. Ken 🐾🐾👍

[OKgal in reply to Iona60]

What Kenu said. You have the card from Genentech. You submit the EOB (in your case, the infusion center does it on your behalf). Genentech then loads the funds on the card, the card is processed to pay the bill.

In my case, I never see the credit card. The credit card numbers is given to the specialty pharmacy into my account with the pharmacy. Every time I order my Copaxone, the pharmacy runs the bill through insurance for co-pay and then checks for funds within their system. I have an individual policy, so there's no interference from the insurance company's pharmacy benefits manager. Payment is applied to my deductible and out-of-pocket max. The PBM's (pharmacy benefits managers) with the various insurance groups are the one's running the show on how the pharmaceutical benefits are applied. In short, if you have to go through a specialty pharmacy, they know who's receiving drug company assistance.

I do know California state government placed a law into effect (New Jersey too, I think?) to prohibit financial assistance from pharm companies. Patients in those states were paying for the medication and submitting an invoice for reimbursement. They are literally being reimbursed before their payment for credit card statement comes in.

I hope this makes sense. I'm getting fatigued and am soooooo sleepy right now. I cannot be held responsible for any missed words meant to be typed.

[Iona60 in reply to OKgal]

Makes so much sense. I was on copaxone and gilenya when a specialty pharmacy. I was guessing that there was some reason that Genentech was issuing credit cards. I'll only have used $6k of the $20k before Medicare advantage starts with my next infusion. I'm wondering if the infusion center can use the balance or if I need to apply for a new card.

[Kenu in reply to Iona60]

You maybe should call and confirm so that you don’t get stuck with a bill. Make sure it is rolling over to new insurance? 🙏👍😊 Ken 🐾🐾

[Iona60 in reply to Kenu]

I'm waiting until that pay for the first infusion before I bring up that I'm switching to Medicare.