Ocrevus & Medicare: I'm sure this has... - My MSAA Community

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Ocrevus & Medicare

mrsmike profile image
24 Replies

I'm sure this has already been asked but here goes. Does Medicare cover ocrevus infusions when done at an infusion center? Thanks in advance.

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mrsmike
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24 Replies
Tazmanian profile image
Tazmanian

I don't know , but good luck

mrsmike profile image
mrsmike in reply to Tazmanian

Thanks!

Allen5280 profile image
Allen5280

It did for me but I'm also fiscally challenged so I get extra help which in my state is Medicaid. I've seen that Medicaid is picking up about 8K and I'm not sure what all that entails. My last infusion which was before assisted living was here at home which was so much better.

mrsmike profile image
mrsmike in reply to Allen5280

Thanks. I've been on the phone for hours with Medicare and they won't give me a definitive yes or no. Such nonsense!

jimeka profile image
jimeka in reply to mrsmike

I hope that you get sorted soon 🤗

mrsmike profile image
mrsmike in reply to jimeka

Thanks. Me too!

pamgarner profile image
pamgarner

call the facility and ask if they take medicare or if you have other insurance,make sure you ask for billing to ask that question,again,patient heal thyself.it is enough to drive you crazy:)

mrsmike profile image
mrsmike in reply to pamgarner

Did that and they replied with a probably, but check with Medicare. Just a viscous cycle.

pamgarner profile image
pamgarner in reply to mrsmike

do you feel like a cat chasing your tail?it will make you uurrggggh!

mrsmike profile image
mrsmike in reply to pamgarner

Absolutely!

Violonchelo profile image
Violonchelo

I have MS since 1999. I have Rebif.

3 times a week.

I read many trataments , but I have the mine since 2005.

Ocrevus for me is a misterious thing as other trataments.

I hope in the future MS had only a pill for all , as well coranovirus only a pill soon. I hope one day.

bavery207 profile image
bavery207

mrsmike I have medicare with anthem as my secondary and all ocrevus costs are covered for me!

mrsmike profile image
mrsmike in reply to bavery207

Thanks! I have Medicare with AARP

Kitsey profile image
Kitsey

I have Medicare and a supplemental plan. While I use Rituxan, it’s covered in full. I too go to an infusion center. Prior to Medicare it wasn’t covered by my insurance. The infusion center may be able to help with your question. I hope you get the answers you need and that Ocrevus works well for you.

mrsmike profile image
mrsmike in reply to Kitsey

Thanks

JTZES profile image
JTZES

I'm not sure about Medicare but my insurance company will not cover it at a hospital based infusion center.

This was based on how the hospital mixed the medication 💊. The hospital based centers mix the steriod with the Ocrevus making it a compound med which they can charge upwards to an extra 40 thousand for.

I did have an issue finding an infusion center that was approved to give me the infusion.

Good luck with your infusions going forward.

JTZES profile image
JTZES

I can't believe that I didn't think about this in my previous post. Contact the manufacturer of Ocrevus and apply for financial aid if you haven't already. They cover what my insurance doesn't.

mrsmike profile image
mrsmike in reply to JTZES

Thank you

1575 profile image
1575

The medication is covered under Medicare Part B which covers 80% counting if you have a Medicare Advantage or Suppliment Plan the infusion will be either 0 or whatever copay amount the the Advantage plan allows. Hope this helps. Peter

mrsmike profile image
mrsmike in reply to 1575

Thanks! It does.

rjoneslaw profile image
rjoneslaw

yes they do.

If you have any problems you should contact your patient navigator at O.They help with everything associated with the drug

twooldcrows profile image
twooldcrows

mine is covered but i also have va threw my husband...

joaneybaloney profile image
joaneybaloney

Who is your provider for the infusion? They should definitely know. Mine handled all of that with my employer-based insurance, but should it be any different with Medicare? Also, the people who work for Ocrevus (really, Genentech) have been really great with talking to me about copay help. Maybe they could help you with this too? If you haven't, start by going on their website.

Juliew19673 profile image
Juliew19673

I think the wonderful people at Ocrevus, would know the answer. Best of luck!

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