I am going to try and make a long story short. I was on Enhertu for nine months and I tolerated it well. Unfortunately progression has shown in my spine. My oncologist suggested the new fda drug Truqap. I am on Medicare and blue cross 65. I was just informed by the oncology center that my co pay would be 3300.00 a month. We also don’t qualify for financial help. Thank you in advance for any helpful advice. I keep praying there might be a solution. 🙏🏻
Lori
hello dear, if you’re in Medicare starting this year you only pay for catastrophic phases and after that it is no copayment thanks to president Biden . I was paying nearly $14000 for IBRANCE each year since 2019, however this year I only paid 3400 and that is it for this year. From next year it will change to $2000 . This should apply for every medication . Good luck
Sima
What do you have as your Medicare supplement? I was told that specialty drugs like Ibrance were not covered. This would be big news.
I have Medicare and Wellcare for Part D Most I have ever had to pay was 700.00 per month for Verzenio but that was 5 years ago
Very interesting. I had been told that specialty drugs like Ibrance were not included...the top tier drugs. When a broker priced UHC for me it was 12k a year for Ibrance.
Here is the description of Medicare reforms that Sima mentioned above. And yes, thank you to Pres Biden.
Did you contact the drug company directly for their patient assistance program? Is that what you meant by you don’t qualify for aid? Check with your care facility, they should have a social worker who might be able to help. I hope you find help. 🤞
My understanding of how the law applies to Medicare is that there is a limit of 3300.00 for all drugs. You likely will pay 3300 the first month and nothing after that. That should apply to all drug plans.
🙏🙏🙏🙏. Hope a solution can be found. I live in Canada and my oncologist has to apply retry year to get my ibrance covered, Theresa
Thankfully I’m over 65 from Ontario Canada and I’m on Letrozole and quisqali and it’s all covered by the government healthcare.
Ibrance is standard of care now in Manitoba - what province is still not covered? My Canada Life insurance covered the first 2 years then Pharmacare took over when it was approved.
So you still struggle for coverage!
Tammie
I had t wait for my prescription once in the last 5 years for the approval of ibrance. Was not a big deal. After my scans in March we will see if radiation worked on my progression in my spine otherwise I will be changing meds. Theresa
Hoping for good news for you. Change is hard.🤞
Yes it is. Hoping and praying I can handle the side effects🙏🏻
Sorry that you have to deal with this addition of stress at the time of a progression.
I am on Medicare as well. My January copay for Piqray was also 3000. Ugh. But— after you take care of your deductible it goes down.
I’m hoping that it’s just one month of this outrageous copay then reduces down to outrageous but not unreasonable.
Best wishes to you!!! Cindi
I was told by my oncology center that my Ibrance would be 3300 a month as well, which I knew was incorrect because I switched to Medicare with an advantage plan and was very careful to know exactly how much I would have to I pay. Otherwise I would have used Cobra until I got assistance. Who can afford that? After several phone calls to the specialty pharmacy and my plan it turned out that after the first month copay of 3300 a cap is reached and no copay for the rest of the year. Next year people will be able to “smooth out” the payments and pay 2000 in monthly installments. It appears that the specialty pharmacy only sees month by month. I am a little shocked that no one seems to know that the Medicare laws have changed. So, check it out if you can, I think it applies to all cancer drugs.
so sorry but insurance can be a pain. I never have had to pay for my cancer meds.no copays. I have Medicare and plan g united healthcare. There are patient assistance programs try the company direct and the pan foundation that gives grants. Maybe you can try less expensive ask the onc. Forgot to ask if I v because mine are oral. I wish you luck🙏🌹
What Threadsgirl wrote is so true. Since Truqap is an oral drug, it should be covered under Part D of Medicare. Once you reach catastrophic coverage, the drug is free the rest of the year. Your max cost should be $3300 this year and then $2000 in 2025.
$2.000 out of pocket CAP beginning January 1, 2025. No matter how much your drug costs. A miracle thanks to the Biden administration. No matter what your political beliefs we need to preserve this great gift of a $ 2,000 cap in oop expenses.
Yes, this is awesome. Thanks for your reply
Good news!
Good news!
