insurance issues

Dear folks is anyone taking Ocrevus having trouble with insurance trying not cover infusion?

[NorasMom]

I voluntarily stopped it after the 2nd half-infusion, but by the time I would have been ready for the next round my insurance had unexpectedly stopped covering it. I learned from another source, because they never notified me. Good luck!

[Jesmcd2 CommunityAmbassador]

Hi Hidden yup a lot of people have trouble getting started, here is a link to help you get started... mymsaa.org/ms-information/p... give mymsaa.org/ a call next week and they can help you out also!! [phone] !

Others on here will give you other hints, I hope!😂 🤗💕🌠

[ahrogers]

My insurance covers it but I have a $5600 copay per year. Luckily, the drug company has a copay assistance program that covers almost the entire copay.I had tried 2 other DMTs before Ocrevus so that may be why I didn't have any trouble getting it covered. I started it on a clinical trial before it was approved.

[Hidden in reply to ahrogers]

Hi thanks for feedback I also have been on several DMTs since diagnosis, some I reacted to badly right away , but the last one did ok for 8 years before it started causing migraines. Which is why I switched

[ahrogers in reply to Hidden]

I wonder what excuse they are using to not cover it then. Hopefully your doctor can do a peer review with the insurance company and get it approved

[Neworleanslady]

My story is much the same as ahrogers’ although I didn’t start on clinical trial and failed on 3 other dmts

[152114randal]

If your doctor recommended a particular drug and your insurance company refuses to cover it you should immediately file an online complaint with your state’s insurance commissioner. It is very easy to do and will only take five minutes or so. Be sure to include your telephone number. The insurance companies monitor these complaints in real time or within a day or so and take complaints to the commissioner seriously and you should be hearing from them within one week. Over the years I have had to resort to this several times and ALWAYS with a favorable outcome. Never let insurance companies make decisions about your health. Good luck.

[Jesmcd2 CommunityAmbassador in reply to 152114randal]

That's good to know 152114randal thanks! 🤗💕🌠

[Hidden in reply to 152114randal]

Thank you for the info

[Tazmanian]

My last couple of infusions I've had to jump through hoops to get it paid for, I finally got it paid thanks to my wife

[Cutefreckles72]

I am currently having the same problem. My insurance covered my last 6 infusions of Ocrevus at the hospital. Now my insurance company will only cover my infusion if I go to an infusion center or do the infusion at home. If I had heart or lung issues, my insurance would allow me to have my infusion at the hospital. I found an infusion center near me. My neuro dr. faxed the order to the center and I am just waiting for a response.

[Hidden in reply to Cutefreckles72]

Best wishes hope all goes well

[Mollyabigail]

For fear of jinxing something, I am afraid to comment, bentbikeguy! So far, my insurance has covered most of my infusions. But I have only had 3. The expense of an infusion is scary!! I am making a mental note of randal's comment above. Best wishes dealing with your insurance folks. 🙏