FUBAR.

[dailygrump40]

I was supposed to get my infusion 2 days ago. But my copay for the medicine (Ocrevus) was gonna be over 6,000.00. 20 percent. So the infusion center said they didn't expect I'd even want to get it and to call Genentech to get on copay assistance. What sucks even more is my medication has been all meesed up. The Horizant being denied and the hoops I had to jump thru to get it back. My baclofen pump is giving me the signals of my dosage being off. I was at the pump Dr Wednesday to get my pump refilled and he even told me he won't mess with the dosage until everything gets straightened out and then he'll adjust it if needed.There are moments i can walk. Not far but it's something. I just pray it's not a relapse.

[rjoneslaw]

I hope things work out for u

[Hidden]

Oh boy. It is intolerable to have to deal with all these roadblocks and MS. It's all about the money, not people. I'm sorry you're dealing with this.

[Jazzihorsecat]

I am so sorry you're goin through this daily, This is one of the many reasons, I am trying to reverse M.S. All naturally!😀👍 By getting my gut cleaned out with Ann Boroch's book, "Healing Multiple Sclerosis", this life changing book has changed mine & many thousands of other people's lives for the absolute better. There are awesome all natural recipes, & treatments in it! I have been on it for 6 months now, & I'll have to say, I am feeling more stable, more regular (no more constipation), & just over all much better. Cannot wait to get on a 🐎again, go riding, very soon. Probably next weekend, it's too busy this weekend. With memorial day. But I highly recommennd this to ya. Up to ya though. Lots less $$$pent. Trust me on that 1! Have a grwat weekend brother.👍😀🌼🌺🌻🍀🐦

Jazzy🌹💜

[goatgal]

The health care system in the U.S. is complicated by multiple issues. Very few of us are satisfied with it, and it is at the top of the list when people are polled about their concerns. But, without congressional action, little reform is likely to occur. Every single time an insurance company denies coverage for something vital to our health and well being, we should be programmed to immediately inform our Congressional representatives. Polls are less likely to affect reform than individual constituent voices. Most in Congress want to keep their seats and are always focused on the next challenge. Without constituent pressure to act on specific issues, they are unlikely to do so. Let your congress persons know of your situation. This can be done by email, phone, or letter. They need to hear from each of us on this issue of affordability, and they MUST protect pre-exisiting conditions whatever they do.

[ahrogers]

I get copay assist for Ocrevus thankfully. My insurance deductible is $5600 per year. I had my infusion mid January and they paid $5500 of my deductible. It was perfect timing because I needed a hysterectomy at the end of January and all but $100 of my out of pocket was covered already.

So you know how it works, the doctors office or you need to send Genentech the itemized bill and EOB for them to process and let you know how much they will cover. This can take over a month because you have to wait for the itemized bill. They give you a credit card you then use to pay your portion once they have loaded the amount you can charge.

I hope it gets worked out quickly!

[dailygrump40 in reply to ahrogers]

This was how it was explained to me. Because my infusion is late. It is to be pushed thru. They've already sent my nuero paperwork to be filled out and sent back to be reviewed for the decision to be made by the end of next week. Then (by my request) they will call my infusion center to set up delivery and so they know who my infusion is. What was really interesting was. They were going to send it to the infusion center at my nueros office and I told them NO. I use a different infusion center. They thought I changed nueros so I had to explain why I don't infuse at my nueros. I said my nuero is 3hrs away. The infusion center I use is less than 1 hr. The person I was talking to said " oh. That makes sense." So as soon as I'm ok'd. Hopefully by the end of next week. My infusion will be scheduled.

[dailygrump40 in reply to ahrogers]

Hopefully my reply didn't sound like I'm being a smarta$$. If it did. I apologize.

[ahrogers in reply to dailygrump40]

Not at all 😊

[carolek572 CommunityAmbassador]

I hope that things get straightened out for you soon. Sounds like your medical team is aware of your situation and is assisting you with this one.

[mrsmike9]

Oh, lordy. If it's not one thing it's 12 others... So sorry.

[IFwczs]

I just got back and saw your post. Always call Genentech co-pay assistance - their co-pay is insanely high, I think 21K per year. Don't listen to any infusion center.