Help!! In panic mode! My mom (71) was diagnosed with metastatic breast cancer (pleural lining of her chest cavity) on Tuesday (12/31/19). Her oncologist has prescribed Ibrance. She is on Medicare, with a supplemental program and a drug plan. The drug plan is quoting 2800 a month. She and I cannot afford that. Pfizer is closed to new assistance applications, as of today 1/3/2020. I am contacting her oncologist office Monday (1/6/2020) for assistance as they mentioned financial aid. My primary concern is that she lives with me due to financial needs and most (If not all) programs will consider my income as hers. Our accounts are separate and we have more of a roommate agreement on a financial level (emotionally we are family obviously but she does contribute to groceries/utilities). Will my income hamper her ability to qualify or diminish her grant amount? I’m envisioning a situation where I am forced to choose between my financial stability and my mother’s life! Any help is greatly appreciated. ❤️
Senior parent recently diagnosed. Dau... - SHARE Metastatic ...
Senior parent recently diagnosed. Daughter caregiver needs Ibrance funding HELP!!!
What state are you in? Is open enrollment still open. You could find a Medicare Advantage Plan like Kaiser (in California) that would have better drug coverage.
Speak with the Oncology Social Worker in your docotors office or hospital. In California, open enrollment is until January 31st.
We are in Georgia. No, open enrollment ended in December. I've contacted the Oncology office to get the financial aid process started. Hoping to hear something soon and it's not too lengthy of a process - further delaying her starting the medication. Thanks for replying!
Checkout the PAN Foundation.
Hi Susan,
Out of curiosity, I checked out the PAN foundation and do not see breast cancer on the list on their website...Do you have any advice on how the original poster can get access to that assistance? Thanks!
Metastatic breast cancer is listed. You have to sign in and fill out a form. They tell you right away if you qualify.
It was put in Jan 1st. I just got money from tbem
Hi Susan. Yes, I've looked at them. I'm trying to go through the oncology office first and let them do the heavy lifting. Trying to give the established process a chance, but it's hard waiting on other people. Thanks for replying!
You are welcome.
You mean to tell me Medicare drug coverage does not cover Ibrance? How does anyone afford this? There has to be a way this is covered. Even supplemental insurance doesn’t pick up this payment?
Medicare Part d and Medicare Advantage is what I just read covers Ibrance.
I am on Medicare with a part D drug plan. The first month's copay for Ibrance was about $1200. The second month was just $600 because the first month was enough to put me into and out of the "donut hole". My oncologist's office has its own pharmacy and they have a person who knows about and finds grants that one can qualify for. After that they go to the drug company. My mom, 94, also lives with me and only has her social security income. I don't recall if that entered into qualifying for the grant but I did have to submit copies of my tax returns (I blacked out my social security number). I don't declare my mom as a dependent, because she isn't, so maybe the subject didn't come up. I sure hope that there is more assistance once the initial grant runs out, because I can't afford such high copays. I am 72, my recurrence showed up in a lymph node by my clavicle just 2 years after the first diagnosis. I try to have a positive attitude but it's not always easy! I would think your oncologist would work with you to get financial help to pay for the drug - no one should go without lifesaving medication.
I have MBC started Ibrance in May the social worker at hospital found grants right from the start haven’t had to pay now changed to taxol still covered you shouldn’t have to pay at all
Completely agree! Mom has Medicare Parts A/B and a supplemental plan. She can't afford Part D/Medicare Advantage, so she has a separate drug plan (WellCare). They require that we go through the CVS Specialty pharmacy, which is mail order. Currently we are waiting on them to get their ducks in a row to even approve the order from the doctors office. I've been in contact with both WellCare and CVS specialty to try to grease the wheels, but ultimately it doesn't matter if we don't have the funds to pay for it.
I do not claim my mother as a dependent so hopefully that will help with the financial piece.
Thanks for replying!
You can make a rental agreement that the person paid x amount to live w you. Since she is helping with food it's obvious she is not living there for free. In that way they dont count you salary as her/him. Then she can take the rental agreement when she is filling the Medicaid and food assistance. I think you should try. If she can get Medicaid she will be fine bc they pd in full Ibrance.
My brother did that when he move w me and his family bc I couldn't support 4 ppl!
I have a friend that she has both Medicare and medicaid but not sure what she did to get it. She has a condition on her head that cause horrible migraines every day.
So with the rental agreement, do you have to show their monthly contributions to the household as rental income on your taxes? I'm definitely looking into Medicaid but trying to let the oncologists office do the heavy lifting for now. Waiting to hear back from them on what options we should start with. Thanks for replying!
No, I didn't it. They put $200 for monthly rental and they only live with me 2 months.
Once they were in better position financial they move out, but they have medicaid for one year. Most ppl don't report that when they rent out a room, but you will have to make that call.
they actually didn't paid me anything, but they help me with the groceries and electricity during that time.
why do you have to show your income? you guys lives together, but that's doesn't mean are one family. Are you claiming her as dependent? I know she does need to show her income and that she is citizen and nothing else. However if she make alot $$$ in social security then you can do the rental agreement, so they will see that as expense. They don't even ask for bank statement. At least in Georgia we don't need to. I asked them and they said no, bc i only ask for insurance and nothing else. If you ask for ebt yes they will ask for everything.
Depending on what state you two live in, she might qualify for Medicaid as well as Medicare. Most oncology practices have somebody on their staff who handles financial information for patients and can find resources for those of us who need help paying outrageous prices like this. Another bit of info that may help you feel better is that alot of us who were diagnosed with metastatic breast cancer a while ago managed well without targeted meds like Ibrance. I was diagnosed in 2004, well before Ibrance, and got nearly five years from first line treatment of Femara (Letrozole) and then over 9 years on Faslodex. She has some things going for her.....those of us diagnosed when we are older tend to have slower, less aggressive cancer cells than younger women, and Estrogen receptor positive cancer often responds well to treatment. Does she have lobular cancer? It tends to metastasize to places like the tissues lining organs alot more often than ductal bc does. I have lobular and so far it has not gone anywhere besides bones, where it was when I was diagnosed almost 16 years ago. Getting the diagnosis is pretty upsetting but most of us find a new normal and settle in --but that takes awhile! Personally, I found that it was more upsetting to me when my mother had metastatic lung cancer than having this cancer myself. As "the patient" we get to make the decisions and take the treatment whil e as family, we can't really do anything directly against the blasted cancer........ but i bet your support means alot to your mom! And you don't have to put your own financial situation in jeopardy! I'm sure your mother wouldn't want that! And in the big picture, it's unlikely that when exactly your mother starts Ibrance won't make much difference. Most of us have some lag time between diagnosis and starting treatment. It was a month plus a day for me. Diagnosed 3/1, took first pill on 4/2. The one piece of advice I give people who have been diagnosed with cancer is to get a second opinion from an onc who specializes in the type of cancer they have. For your mom, that would be breast cancer. On the home page of this group, there is a list of resources (right hand side of the page) and that lists the Comprehensive Cancer Centers, the top tier of CC in the US. They have specialized oncs who do research and see patients, including for second opinions. Her own onc should encourage that and help get an appt for her. Those oncs are on top of the latest findings and recommendations for treatment. Good luck to both of you.
Thanks so much for the information. It certainly helps hearing that the delay in starting Ibrance might not make a significant difference in success. Mom has been quite upset in the delay, but she knows that I'm trying my best to get thru all the hurdles. I have reached out to the oncologists office for financial assistance, so now I'm waiting to hear back on options. Waiting...waiting...waiting. It's so hard because this is the ultimate "group project" and I was never the type of student that did well with those. Waiting on others to do their part just never worked for me. 
Thanks for the reply!
Apologies to all for not responding. Looks like the notification emails were going to my junk folder. I’ll look over everything everyone sent and respond soon! Thank you all for taking the time to provide input! ❤️
It looks like you've gotten good advice from people here.
I guess I'm lucky, all things considered. I have traditional Medicare (i.e., not Medicare Advantage), and a secondary medical plan which I use for co-pays, deductibles, and for drugs (I'm not on Medicare Part D). I pay $50/month for a three-week supply of iBrance, 125 mg, which I've been on for over three years. The retail price of this drug is $10,000, as I see on my Explanation of Benefits from the secondary insurance. I bring all this up to illustrate what a mess the healthcare system is in the US and why it needs to change. This thread shows not only how unaffordable drugs can be, but also all the different prices that different people are being quoted for the same drug!! I love my country dearly, but I scratch my head trying to figure out why we're the only developed nation in the world with healthcare like this.
I'll get off my soapbox now. Good luck to you, George5545.
Hi Blue! Would you mind sharing which secondary medical plan you use? You can private message me if you don't feel comfortable sharing on the thread. If not, I understand, but $50/month would certainly be something mom and I could do. Thanks for the reply!
Hi. I will be in the same situation as you in a few months, and would appreciate knowing what your supplemental coverage is
Can you message me? Thanks!
What state do you live in and what insurance? I’m at a lost because they are not guaranteeing Ibrance and I have to choose a plan for Medicare. I’m trying to sort it all out now.
How do I PM on this site? I’m afraid I don’t know how.
Hi Blue! There should be an icon that looks like two chat bubbles at the top of your screen. If you click that, it will open a place where you can search for my user name and compose the message.
I’ll send you a message and you can just reply to that. Thanks!!!
Hi All!
I wanted to let you know that we successfully received a grant to cover the cost of the Ibrance for the next 5 cycles. While I had wished we had received enough for the entire year, I guess beggars can't be choosers. Mom has been on the medication for about a week and is tolerating it well so far. We will see the oncologist next week for a blood test to make sure things are good with her internally. It's been quite the roller coaster.
Last night, I think reality finally came crashing down on mom. Knowing that there isn't a cure and that she will have to be on treatment for the rest of her life has definitely put her in low place mentally. I'm trying to be patient and keep an eye out for any depression symptoms. It's hard to know the difference between processing and clinical depression! Especially at this early stage. I went thru a period of intense traumatic grief myself a few years ago, so I am very familiar with how the mind can process things and how slow it can be to do so!
If any of you are willing to share, I'd love to hear about your experience now that you have been living with MBC for months/years/decades(?!?). Mom has expressed fear of losing access her medication, having a lapse in coverage due to losing grant money/or timing of grant money, and just general anxiety about the fact that the cancer will never truly go away. I'd love to hear from anyone who has been on this path for a while and can share their experiences (positive or negative!). I'm trying to help her realize that she is on the BEST medication available for her particular cancer and that (as her surgeon/oncologist have told her) people live for many years without issue - going about their almost regular lives. But she just isn't hearing me. 
Thanks for any insights you may have. <3
I see you've had a lot of responses but thought I'd throw in another one. I'm 73 and live on only SS and 2 small pensions - about $2300 a month. The specialty pharmacy at the hospital where my onc practices has found me grants for the 2 years I've been in Ibrance. I haven't paid a penny. Someone mentioned PAN which I think has provided assistance along the way. I don't even know where the funding comes from; there have been several different funding organizations over time. I just know my co-pay has been covered every month I've been on the drug. Is there a social worker at the hospital where your mother gets treatment? They should be able to help as may the specialty pharmacy.
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