Paying for Ibrance on Medicare

[bankusboysmom]

Does anyone know if Medicare Part D covers the cost of Ibrance?

[Zebra2018]

Hi, I have Medi care and my out of pocket cost for IBRANCE is almost $12000 a year with Medicare. If you have income you are not eligible for other programs, believe me I tried! 😉

[bankusboysmom in reply to Zebra2018]

Yikes! I was afraid that’s what I was looking at...so long retirement vacations. Thanks for replying. Hope you are doing well.

Melinda

[Zebra2018 in reply to bankusboysmom]

How much dose it cost now?

[bankusboysmom in reply to Zebra2018]

I don’t pay anything. My husband had excellent insurance that ended when he retired but I was able to go on COBRA for the last 16 months (I think 18 months is the longest they allow). Now I don’t know what our costs will be. From previous posts I’ve gotten a lot of good information so I’ve got to start researching.

[Zebra2018 in reply to bankusboysmom]

Yes you should!

[ChrisVict in reply to Zebra2018]

Really that can’t be! I thought I had the most expensive insurance now and my out of pocket for all medical for me alone is 8k and I’m told next year 9k. What if you get part B does it help and supplementary drug plan if necessary. Higher costs at a time when income goes down just does not seem logical but a lot of things from this disease are unfair!

[ChrisVict in reply to ChrisVict]

Also ask yourDoc or Parmacy for a special coupon or request for help I didn’t pay for it. It was the PT , shots and MRIs that add up.

[Zebra2018 in reply to ChrisVict]

I have supplemental insurance with Aetna and part D with WellCare. I don’t pay for faslodex or xgeva injections Medicare and Aetna covers that! However IBRANCE is a tier 5 drug that is covered by part D RX! Believe me I tried every possible avenue I could! You have to fall in some categories of income in order to be eligible for coupons or discounts!

[bankusboysmom in reply to ChrisVict]

As I find out information I will pass it along.

[NShaft in reply to Zebra2018]

Do you have a supplement? I will be going on Medicare next summer and trying to figure out what costs will be.

[Zebra2018 in reply to NShaft]

Yes I do! But this drug is so expensive! And I am not eligible for coupons or any other help!

[USIrishcolleen]

I would check to see if you oncologist can recommend you to a foundation. Stanford has a foundation that helps those pay for Ibrance that need the assistance. That would be ME! I was told that each cycle of Ibrance is $14,192. Absolutely absurd!

[bankusboysmom in reply to USIrishcolleen]

Thanks! Adding Stanford to my list of research.

[Photo-Bug in reply to bankusboysmom]

Depending on your income the drug company may send it to you at no charge. The form should be online. There is also PAN Foundation. Since this is nearing the end of the year, they might be out of money. The 1st of the year is the best time to get a grant from them.

Hope this helps.

[Klamato]

Hi, I applied directly to the company for assistance and received it monthly for free! It must be that you may have to qualify. Ask your doctor about the patient assistance program.

[Selmac]

If there are 2 people in your household, your income cannot exceed 80,000.00. Ours is a bit higher so they looked at all our expenses and approved. I then switched Oncologists who is with a research university. A brea ssd t cancer specialist. They've not charged me for any of my cancer meds.

[Calm4]

My oncologist office was able to connect me with a foundation that agreed to pay my co-pay for my chemo drugs for the next year if I had insurance. I have Aetna Medicare and is a good choice for me. The foundation is Patient Advocate Foundation patientadvocate.org/

I am on my 4th cycle of Ibrance.

[bankusboysmom in reply to Calm4]

Thanks, I’ll look into the patient Advocate foundation.

[Calm4 in reply to bankusboysmom]

I hope the Foundation is able to help you. The best to you with your treatment.

[bankusboysmom]

Thanks so much for information. Hope you’re doing well.

[ChrisVict]

Omg I will be soon going on Medicare and whatever part I have to go on not to pay for the exorbitant drug costs. I truly hope it does not become a nightmare most of my drugs have not cost anything coupons, some special process the specialty pharmacy in my insurance applies to the drug company. My deductibles and premium Are high now that’s why I work but once income goes down treatment cannot go up. Again what is considered a level to help you 80k for 2 people? Maybe if I stay with my oncologist she part of a research hospital I can do the same.

Thank you and anymore insight I am dreading the switch.

[bankusboysmom in reply to ChrisVict]

I wanted to get back with you on what I've learned regarding paying for Tier 5 drugs (Ibrance) on Medicare. Someone on this site recommended I contact SHIP (which I think is State Health Insurance Program), every state has one.

I'm in Texas and once I contacted them, they sent me to the Department of Health & Human Resources, once there they sent me to the Commission on Aging in my area (my county). The lady I spoke with was very helpful. According to her, every state has such a department specifically to help seniors. She gave me info on Part D plans that were available in my area. I had not been able to find these on my own and when I talked with "advisors" with different plans, they never mentioned any of these. According to Yvette (who interestingly is part of United Way in our area) my best choice is to get a Supplement for Part B (the medical part), a separate Supplement for Part D (the drug part), and then, if I want, a separate Supplement for dental/vision/hearing.

The other thing she mentioned, which I thought was interesting, is to stay away from Advantage Plans. According to Yvette, Advantage Plans pay less than Original Medicare and the doctors are unhappy and beginning to drop coverage for Advantage Plans.

Hope this is helpful. Once I got to this point, I felt like relief was in sight. In talking with the Advantage Plan "advisors" and even some Supplement Plan "advisors" I was looking at out-of-pocket cost of $12K to $17K annually and this was only for the Ibrance!

With a separate Part D plan, I'm looking at about $500 for the month of Jan (all my scripts, not just Ibrance), from there it goes down to $200/month 2-5, and then about $175/month 6-12.

Again, I hope this helps. Geez, it's hard enough to deal with being a metster, but cancelling retirement just so I can stay alive...not sure about that.

Melinda