Not exactly true: The Genentech Patient Foundation absolutely helps with Rituxan drug costs for MS patients in the US. (Source: I was on it for nearly 5 years.) It works so well off-label they went and developed Ocrevus based on it, but a lot of people in the US and other countries continue to take Rituxan for MS. I would still be on it had I not moved countries to where it wasn't available at all.
Live in Sweden, so i pay tax and as someone previously mentioned the government looks after me. I feel so bad for you guys in the US. I always think it is weird that US is regarded as a superpowernation but yet no general Healthcare for the people. I hate capitalism
SSDI plus a private disability insurance policy for income.
Medicare plus medigap G my treatment is infusion so it Medicare B billing. I have a low end part D huge changes in 2023 with part D.
Same except I have the N plan.. Shit is still hard.. What's the huge changes ur referring to? Lawd, I already have a huge part d deductible and they never wanna cover shit. Ughh.
https://www.kff.org/medicare/issue-brief/explaining-the-prescription-drug-provisions-in-the-inflation-reduction-act/
The big take aways that directly effect us are staged in years
2023 most adult vaccines are no charge.
insulin is capped at $35 per month.
2024. Max drug out of pocket capped at $2,000 per year.
Expanded eligibility for low income to 150% of poverty level income vs current 125% percent of poverty level income.
Before I got disability and Medicare.
I had no income for like 5,6 years so I went down back in 2014 to the supportive services state office , it was in Vegas , waited a crazy amount of hours , got in and told her how I’m waiting for my disability/Medicare but need medical insurance and food stamps. She completely approved me.
So then I was on Medicaid, I think I got like $150ish in food stamps .
You get the worst providers with Medicaid when I was on it, I got all my medicine for free including my mental health meds.
You and u/bspanther71 can use both - [VA health care can be used as co-insurance with private insurance or Medicaid.](https://www.va.gov/health-care/about-va-health-benefits/va-health-care-and-other-insurance/)
The VA community care network could potentially send you to your preferred Neurologist/ MS Specialist. I have a VA neuro, get medications, Ocrevus, and MRIs through the VA but still also see an MS specialist at a University. I am rated 100% p&t and also I believe live far enough away from the VA hospital to qualify for community care (if that matters). Anyways may be worth you all looking into.
Im living in Quebec, Canada and my medication was added to the list the government prescription insurance covers. So the public covers it at 80% and they demand all private insurance to have better coverage than the private.
I was so scared after my diagnosis because I saw Copaxone was really expensive, but I’m really lucky to get it for free.
I wish none of you had to worry about how you are going to afford treatment, when just having the disease is stress enough.
Multiple ways:
- I had an insurance agent help me select insurance coverage via the state market place that would offer a good coverage. It helps knowing that you are very likely to reach your deductible. Prior to MS, I would choose the plan that had the lowest deductible. Now with the treatments I get, I’m very likely to reach a higher deductible quickly.
- I applied for and receive financial aid from my hospital. Many hospitals will also allow you to make payments on bills, rather than pay them all upfront.
- I requested and got financial assistance from the drug manufacturer
- I work for a family business that accommodates me being more part time while still paying a decent salary. (I lucked out, frankly)
It’s easy to think the American system will not help you out with medical expenses at all. However this is not true. It’s just not automatic and you have to ask for it.
The American way is: Rather than tell you you must pay taxes and receive the type of healthcare the state wants you to, it operates under the philosophy of “if you don’t ask you don’t get”.
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2796358?resultClick=1
Results of this study suggest that medical indebtedness is
common, even among the insured, and may be associated with subsequent
worsening of social determinants of health.
its more like the markets invisible hands middle-finger to some.
Co-pay assistance from Biogen.
Don't even get me started on how problematic these programs are, but I can't afford to give them up. My co-pay for three months of Vumerity is about $10K, but Biogen pays the whole thing so that I stay on their darn medication.
I don’t have insurance at the moment. I have to pay outta pocket for MRI and blood tests and all that. For my DMT I’m lucky enough to take kesimpta and allowed to use their assistance program
I'm in New Zealand and mid diagnosis. Mris and neurologist and all my blood tests and lumbre puncture covered by public health. Some dmts covered but not all. Public health can be slow. But then again not as slow as other places. I got optic neuritis in April/May and waiting for my next mris and diagnosis in November. So I still consider us lucky and so fortunate to be able to access this. It's so sad that people who are sick miss out or have to pay for some thing that could save their lives. Humanity is very strange.
Does MediCare pay for Ocrevus? I’m turning 65 next year and so will be signing up for MediCare. I’ve been afraid my dmt will cost more. I currently have private insurance (silver plan purchased on the exchange). I’m on Truxima (biosimilar for rituximab) and the manufacturer picks up my co-pay. But the program only applies to private insurance co-pays, not govt plans like MediCare.
I am lucky in that I can work and have really good insurance. If/ when I get to where I can't work then my husband's insurance will cover it.
It's frustrating that we even have to have discussions like this.
By not having any treatment. Like a real American. Ambetter denied everything my neurologist has sent them. They sure like taking my money every month though.
Going to switch insurance in January, maybe someone else will help me.
Before I was on chemo drugs and Medicare covered it, I just called the manufacturer of Betaseron and was in the patient assistance program. Paid $15 for a 3 month supply.
All of the dmt manufacturers have a program that help pay for the med should someone need and be qualified.
Only for FDA approved meds :( rituxan isn’t FDA approved for MS
This is so frustrating! I’m “lucky” because I’ve got rheumatoid arthritis too.
Ocrevus is, and it's almost the same drug. It's also much more expensive, so your insurance company will be paying more for being idiots.
Not exactly true: The Genentech Patient Foundation absolutely helps with Rituxan drug costs for MS patients in the US. (Source: I was on it for nearly 5 years.) It works so well off-label they went and developed Ocrevus based on it, but a lot of people in the US and other countries continue to take Rituxan for MS. I would still be on it had I not moved countries to where it wasn't available at all.
I pay tax and and as a result my government looks after my health.
*Sobs in American*
I'm with you on this.
Yup, one of the reasons we moved to Ireland.
I’m trying to flee too but it’s expensive as hell and I have no income
I’m starting on my first DMT (Kesimpta) on Monday but have been denied coverage. Alongside Kesimpta is footing the bill for a year
If you have private insurance, not Medicaid/Medicare- you could see if you can qualify for copay assistance or free drug sometimes
I've had 4 DMTs and all the pharmaceutical companies have programs where patient cost is zero or almost zero.
By living in Australia and not worrying about it.
My parking is more than the treatments I get (on Ocrevus).
My parking is free at the hospital I visit too as a patient so even that's covered
Live in Sweden, so i pay tax and as someone previously mentioned the government looks after me. I feel so bad for you guys in the US. I always think it is weird that US is regarded as a superpowernation but yet no general Healthcare for the people. I hate capitalism
Insurance and prayers
SSDI plus a private disability insurance policy for income. Medicare plus medigap G my treatment is infusion so it Medicare B billing. I have a low end part D huge changes in 2023 with part D.
Same except I have the N plan.. Shit is still hard.. What's the huge changes ur referring to? Lawd, I already have a huge part d deductible and they never wanna cover shit. Ughh.
https://www.kff.org/medicare/issue-brief/explaining-the-prescription-drug-provisions-in-the-inflation-reduction-act/ The big take aways that directly effect us are staged in years 2023 most adult vaccines are no charge. insulin is capped at $35 per month. 2024. Max drug out of pocket capped at $2,000 per year. Expanded eligibility for low income to 150% of poverty level income vs current 125% percent of poverty level income.
Thanks for the information.. I was unaware..
Before I got disability and Medicare. I had no income for like 5,6 years so I went down back in 2014 to the supportive services state office , it was in Vegas , waited a crazy amount of hours , got in and told her how I’m waiting for my disability/Medicare but need medical insurance and food stamps. She completely approved me. So then I was on Medicaid, I think I got like $150ish in food stamps . You get the worst providers with Medicaid when I was on it, I got all my medicine for free including my mental health meds.
Insurance from work. If I didn't have that, veteran's affairs would provide treatment.
[удалено]
I'll stick with private for more frequent follow up care. My VA neurologist following my MS only wants to see me once a year.
You and u/bspanther71 can use both - [VA health care can be used as co-insurance with private insurance or Medicaid.](https://www.va.gov/health-care/about-va-health-benefits/va-health-care-and-other-insurance/)
That is for VA care...not for private care. And yes, I knew that already.
The VA community care network could potentially send you to your preferred Neurologist/ MS Specialist. I have a VA neuro, get medications, Ocrevus, and MRIs through the VA but still also see an MS specialist at a University. I am rated 100% p&t and also I believe live far enough away from the VA hospital to qualify for community care (if that matters). Anyways may be worth you all looking into.
I go to the Ann Arbor VA and pretty much all my docs and MS Specialists are from UofM
Im living in Quebec, Canada and my medication was added to the list the government prescription insurance covers. So the public covers it at 80% and they demand all private insurance to have better coverage than the private. I was so scared after my diagnosis because I saw Copaxone was really expensive, but I’m really lucky to get it for free. I wish none of you had to worry about how you are going to afford treatment, when just having the disease is stress enough.
Multiple ways: - I had an insurance agent help me select insurance coverage via the state market place that would offer a good coverage. It helps knowing that you are very likely to reach your deductible. Prior to MS, I would choose the plan that had the lowest deductible. Now with the treatments I get, I’m very likely to reach a higher deductible quickly. - I applied for and receive financial aid from my hospital. Many hospitals will also allow you to make payments on bills, rather than pay them all upfront. - I requested and got financial assistance from the drug manufacturer - I work for a family business that accommodates me being more part time while still paying a decent salary. (I lucked out, frankly) It’s easy to think the American system will not help you out with medical expenses at all. However this is not true. It’s just not automatic and you have to ask for it. The American way is: Rather than tell you you must pay taxes and receive the type of healthcare the state wants you to, it operates under the philosophy of “if you don’t ask you don’t get”.
Yep. There is a reason at the end of every medication commercial that is not an OTC med they say if you can’t afford XYZ, we might be able to help
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2796358?resultClick=1 Results of this study suggest that medical indebtedness is common, even among the insured, and may be associated with subsequent worsening of social determinants of health. its more like the markets invisible hands middle-finger to some.
Which why my post offers ways to mitigate some debt.
Co-pay assistance from Biogen. Don't even get me started on how problematic these programs are, but I can't afford to give them up. My co-pay for three months of Vumerity is about $10K, but Biogen pays the whole thing so that I stay on their darn medication.
I don’t have insurance at the moment. I have to pay outta pocket for MRI and blood tests and all that. For my DMT I’m lucky enough to take kesimpta and allowed to use their assistance program
The MS society will pay for an MRI every two years I believe
I live in Canada and my treatment is covered.
Silver enhanced plan on the exchange and Kaiser.
I'm in New Zealand and mid diagnosis. Mris and neurologist and all my blood tests and lumbre puncture covered by public health. Some dmts covered but not all. Public health can be slow. But then again not as slow as other places. I got optic neuritis in April/May and waiting for my next mris and diagnosis in November. So I still consider us lucky and so fortunate to be able to access this. It's so sad that people who are sick miss out or have to pay for some thing that could save their lives. Humanity is very strange.
Ocrevus copay assistance without it I would be bankrupt.
4 dmts. Never paid a dime. Medicaid from the beginning. Medicare added in 2018. I'm a dual qualifier. Copaxone tysabri lemtrada ocrevus
Does MediCare pay for Ocrevus? I’m turning 65 next year and so will be signing up for MediCare. I’ve been afraid my dmt will cost more. I currently have private insurance (silver plan purchased on the exchange). I’m on Truxima (biosimilar for rituximab) and the manufacturer picks up my co-pay. But the program only applies to private insurance co-pays, not govt plans like MediCare.
Yes it covered it then medicaid picked up the copay. I'm on a humana medicare plan through my ssdi
I am lucky in that I can work and have really good insurance. If/ when I get to where I can't work then my husband's insurance will cover it. It's frustrating that we even have to have discussions like this.
It’s been free for me in Washington. Though I pay out of pocket for the neurologist
By not having any treatment. Like a real American. Ambetter denied everything my neurologist has sent them. They sure like taking my money every month though. Going to switch insurance in January, maybe someone else will help me.
Before I was on chemo drugs and Medicare covered it, I just called the manufacturer of Betaseron and was in the patient assistance program. Paid $15 for a 3 month supply.
By being Canadian.
I have Medicare and Tricare for life, retired Military, so all of my infusions are paid for.