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Does Medi-Cal cover Gleevec?


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#1 sunflower

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Posted 31 January 2013 - 06:14 PM

Hi, my monthly insurance premium is going up to an unmanageable rate. I am trying to figure out other ways to get health care and medication. Not sure if anyone would know this, but was wondering if Medi-Cal (the government program in California) covers Gleevec? I tried calling like 4 of their numbers and was just given the run-around, and left with no answers. Thank-you.



#2 ChrisC

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Posted 31 January 2013 - 08:06 PM

Yes: if you qualify for Medi-Cal, Gleevec is covered, as is Sprycel — probably all TKIs are, but those are the two I used.

FYI: It's not an easy process. In the beginning I applied for Medi-Cal while I was still in the ICU, and it takes months to get everything processed. I was informed that it would be good to hire a lawyer, as Medi-Cal can be complicated. They recommended one lawyer, who came to meet with me while I was still in the hospital.

However, one thing she insisted that had to be done right away in order to have Medi-Cal pay for the hospital stay ended up making me ineligable for SSI for three years. In order to finally get Medi-Cal, I ended up having to get help from the local Legal Aid Society, and that took about eight months altogether. During that time I was being heavily pressed to pay the hospital bill and ongoing doctor and lab bills. As time goes on, there is always a challenge to keep Medi-Cal and SSI, which is currently in appeal: they say they want all their money back, having forgotten the law they explained to me a couple of years ago when they approved it. Sigh. All this with extreme brain fog and debilitating fatigue.

Good luck!

ChrisC


Be alert, but not overly concerned.

 

• Dx Oct. 22, 2008, WBC 459k, in ICU for 2 days + in hospital 1 week

• Leukapheresis for 1 week, to reduce WBC (wasn't given Hydroxyurea)

• Oct. 28, 2008: CML confirmed, start Gleevec 400mg

• Oct. 31, 2008: sent home when WBC reached 121k

• On/off, reduced dose Gleevec for 7 months

• April 2009: Started Sprycel 100mg

• Sept. 2009: PCRU 0.000

• Sept. 2011: after 2 years steady PCRU & taking Sprycel 100mg before bed, quit Sprycel (with permission)

• Currently: still steady PCRU, testing every 6 months 🤗

— Fatigue, hearing loss continue, alas, but I prefer to think it is all getting better!

 

 


#3 sunflower

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Posted 31 January 2013 - 11:15 PM

Hi Chris, Wow sorry you had to go through all that. Sounds like a headache. I went through something similar applying for disability, and they denied me. I didn't know that applying for Medi-Cal is as complex as applying for disability. Thanks for the info! I hope that everything gets straightened out for you also






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