I saw the recent post from greaterexp There can't be anything more frustrating than deciding on a new treatment but not being able to get on it because of health insurance. I'm currently waiting for the approval and it's nerve-wracking (new job = new insurance). Last one was super easy.
Is there such a thing as a list of insurance companies and the ones that are known to cover Ocrevus w/o issues vs the ones that decline it?
Should we build such a list?
That sounds like a great idea. Also I think it was Iona60 who said you could phone Ocrevus itself. Let us know how you get on, Blessings Jimeka 🦋 🍫
my neurologist put some paperwork in with the manufacture of ocrevus and they worked with my insurance company and I was able too get the ocrevus. But I did call my insurance company before I got my first dose of ocrevus Just in case
Maybe you should ask your doctor to see what he can do for you.
It never hurts to try.
Ocrevus wasn't on the formulary for my insurance, but the neurologist submitted a medical necessity letter and it flew through. Genentech assigned a patient advocate that helped.
This is my story I shared with greaterexp. What I did before I got on my husband's insurance was call them before I signed up and had it confirmed that they cover Tecfidera. They said they did, and they did.
Here goes my story {don't ever get this insurance):
When I had BCBS of Kansas City through work, I was first diagnosed with MS. It was a miracle the doctor figured it out based on my narrative and followed up with an MRI. I told him the insurance company wasn't going to pay for the MRI, but he mysteriously smiled and said they would. He didn't tell me about his diagnosis at the time. Miraculously, they paid, and the MRI confirmed his guess. When it was time to pick the medication, my MS doctor prescribed Tecfidera ($100K/year). The insurance company actually told me verbatim they were not going to pay for it because it was too expensive and told me to "pick" any other medication. I was outraged and yelled at them "Are you doctors?! Are you God?!" Getting diagnosed with MS was bad enough. Fortunately, I could get on my husband's insurance two months later. It is a small fortune, but they paid for Tecfidera and are now paying for Ocrevus.
I'm on United Health Care insurance and with manufacture aid I had no problems receiving Ocrevus.
For this calendar year United has changed their policy that they will no longer cover hospital based infusion center leaving you too find an infusion center that has a pharmacy on site.
I have been recommended to try rumotolgy infusion centers.
I don't know the actual price of the medication but my last hospital based dose ran $115,000.00 or 300 thousand for the year.
Maybe the FDA needs to lift the ban on generic versions of some of our med's.
I understand there are cost associated with creating a new med but somehow it needs to be regulated.
Just my opinion.
Thank you all for sharing.
Last year, my insurance was Blue Shield of California (PPO) and they were great. Approval for Ocrevus came back in 4 days and pretty much all covered (medicine + infusion center).
Because I have a new job, I'm now with United Healthcare (PPO, I subscribed to the most expensive plan). Insurance request was sent a week ago and waiting for their decision.
I am just impatient and anxious, waiting for it.
Talk to your neurologist, I was able to get ocrevus the first year it came out, my neuro had me fill out an application that was from the drug manufacturer Genentech. I qualify each year for free infusions. It is income based but if your like me, on disability I'm sure you will qualify for this also
Getting Insurance to pay for Ocrevus in children
Ocrevus (financial) help
