Cost of anemia meds once Stage 5 on dialysis - Kidney Disease

Kidney Disease

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Cost of anemia meds once Stage 5 on dialysis

Terkins profile image
9 Replies

I'm barely surviving now on SS as my sole source-of-income. It's sites like this one: drugs.com/price-guide/triferic that make me wonder if I'll survive for very long if I board the dialysis train.

...from $1,546.37

for 1200 milliliters (one dose?)

Comments?

I won't qualify for Medicare for another 12 mos. Even then: Would this drug be covered?

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Terkins
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9 Replies
orangecity41 profile image
orangecity41NKF Ambassador

I am on Medicare and you would have to determine which Part D plan for drug coverage would be the least expensive. Medicare.gov has a calculator to find the best coverage based on your medicines.

If you select an Advantage Plan would have to determine which covers your medicine best. Medicare.gov has calculator too for Advantage Plans

Terkins profile image
Terkins in reply toorangecity41

...so my SS will go up $20./mo. in 2018 which wouldn't make a tiny dent in this one med for survival. I guess my next question is: If you're too sick to work and too poor to afford (dialysis + affiliated care) via Medicare/SS...who decides if you live/die? Do you get a "pink slip" telling you your dialysis is being discontinued?

orangecity41 profile image
orangecity41NKF Ambassador in reply toTerkins

Medicare does cover dialysis and other related services under part a and b and supplement. There might be limitations on services. Medicare Advantage plans might not cover or if do might have a cap. . medicare.gov/coverage/dialy...

Medicines are different and depends on formulary.

Dixidude39 profile image
Dixidude39

My wife and I are grateful that we can afford the insurance premiums for Original Medicare plus Anthem BC/BS "medigap" coverage. Thus we can see our doctors with no co-pays. We don't pay for hospital stays or other covered services/supplies.

But, I always wonder, "How can for-profit insurance companies cover doctor visits, plus dental insurance, plus YMCA "Silver Sneakers," and drugs my wife and I must pay for under Medicare Part D (premiums plus co-pays for each drug)?" Has anyone read a definitive account on how this works? My guess is that medical care must be second class to pay for what the Medicare Advantage plans offer (only a handful of not so good doctors), plus perhaps high co-pays for hospital stays (in only those hospitals which recognize the Advantage plans).

I'd like to know the straight story. I'm not sure those just becoming eligible for coverage know the difference. Also, if you start with an Advantage plan, can you switch to Original (government-funded) coverage, 3, 5 or 10 years later?

orangecity41 profile image
orangecity41NKF Ambassador in reply toDixidude39

Being on Original Medicare and part B supplement I agree with what you are stating. I heard it is difficult to transfer back to Original Medicare, and pay a premium price if you can. This happened to a friend with chronic condition. I think the Advantage plans only want younger and healthier seniors. I tried to get information packet for a new Advantage plan in our area and got a call from service company who basically said since have CKD it would be a problem getting on this Advantage plan. Never got the info packet. Some Advantage plans also have a lifetime cap for a condition, and another friend is almost to the cap.

Dixidude39 profile image
Dixidude39 in reply toorangecity41

Just remembered. About a year ago, as a mentor in BCAN's Survivor2Survivor program, I contacted a retiree. He invited me and my wife to meet with him and his wife at a nearby vacation home. He had headed several nationally known health insurance companies. We had a great face-to-face discussion. This is a man who counted the No. 2 man at M D Anderson Cancer Center as a personal friend. Guess what he said the solution to our broken healthcare/insurance system should be? "I believe we need a SINGLE PAYER system administered by Federal Health and Human Services." I've lost track of this man, but I believe he found out that his BC had metastasized to other organs in his body. Not good news.

ScoobyDoo910 profile image
ScoobyDoo910

I'm not sure how Medicare works but I had to put my son on medicaid. Which since I have 2 insurance plans it covers everything thank goodness but it does make my blood boil when I call epic solutions his home feeding supplies and inquire why his supplies is close to 7,000 a month and get told oh that's the amount we charge but we have contracts with the insurance companies so what's allowed is what the insurance company pays. Wtf. Seriously keep jacking the price up. Another situation if I get a blood test at dorenbeckers it's 1500 dollars and here at crescent for the same blood tests it's 250. I do them at crescent. Insurance is a scam in a way because I try to keep the premiums down because I try to lower insurance for people the more that gets pd out because of contracts the higher the prices for everyone. And how can hospitals charge 32000 for every ivig treatments and tell me that you can order as much food as you want it's the same price while you stay here. Everybody gets charged the same amount no matter what medicine ECT there on. It's not right and they get away with it. A 15m doctor visit 589.00 really. Grr. It isn't fair and some people go without because they are getting away with this. I'll stop now because I 've been trying to figure out how to fix the system and no matter how much I complain it does no good. Frustrated because the system sucks. I know I didn't give any solutions but I just investigate the cheapest suppliers.

Terkins profile image
Terkins in reply toScoobyDoo910

ScoobyDoo910 I register all your complaints and "second" them. Ultimately: No healthcare system can provide unlimited benefits for all citizens. It wouldn't matter how they are financed or organized. There is no "Mother Teresa" healthcare for all. (Even) I've read in Russia if you plan to need a surgical delivery you'd better bring your own durable medical supplies to the delivery room... In Ontario the hospitals are using hallways to accommodate a sudden overflow of patients...

Capitalism is ill-prepared and ill-conceived to render compassionate and/or economical medicine-for-all. Nor (just illustrated) would socialism cure said ills.

Dedicated sisters, brothers, priests, as lifelong religious devotees used to organize and administer hospitals, homes, clinics, etc. Some few still do. Society has allowed insurance middlemen, career politicians, and colleged healthcare administrators to usurp the compassionate care once-forthcoming from the bounty of benevolent, religious vocationals. I was force-birthed (Ceasarean) in such a hospital while my father was between jobs and three sisters were being cared for by mother, four days after Christmas in snowy Detroit, MI. Those religious donors to the common good are long-gone and most of their institutions are closed-or-converted to for-profit operations. Society is paying a heavy price for their absence.

There seems to be little will to have large families from whence those religious caregivers arose. Nor are there swarms of vocations of singles wishing to dedicate lives of service under vows of poverty.

Perhaps the healthcare we wish for is more than we can afford? After all: Whose "children" (aborted?) will volunteer to be the subsistence-paid servants of the ill, the elderly, the feeble? I fear we're reaping the spoils of our own designs--not those of God's.

orangecity41 profile image
orangecity41NKF Ambassador in reply toTerkins

Terkins: I do remember when hospitals were administered by religious organizations, and even medical insurance was non profit. Now all medical is for profit. Medical system does need improvement. Probably strictly for profit is not the answer.

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