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Gap in Insurance - Any Suggestions?


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#1 Tom1278

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Posted 21 September 2013 - 04:54 PM

My last employer -- a very small business -- and I mutually parted ways in late August.  My insurance was cancelled as of August 31.  COBRA wasn't available.

I applied to get on my spouse's health insurance as soon as I could; however, delays in getting the HIPAA certificate from the old insurer and other paperwork snafus in HR delayed the process.  According to HR, my insurance won't kick in until early to mid October.  (It's for state employees, so there's no speeding up the process.)

I have enough Gleevec to get me through to September 28th.  I've put in a call to my doctor's office 2 days ago, and (surprise!) no one has called me back.  On Monday, I am going to call Novartis.

Has anyone been in this situation before and figured out a way to get medication? 

I can't afford the $6,800 cost for a 30 day supply.  It might be possible to do a retroactive adjustment to the start date of my insurance and put in a claim for reimbursement, this makes me VERY uneasy as they are clear that (1) it might not be accepted and (2) they may only cover part of it.


Diagnosed with CML in July 2012 (33 years old)

MMR since March 2015; E453K mutation

600mg Gleevec

 


#2 hannibellemo

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Posted 25 September 2013 - 06:13 AM

Tom,

I don't know your history and where you are in response to Gleevec. Does your onc know of your problem with getting Gleevec for 2-3 weeks? It might be that you could skip your dosage for that period of time and not have any problems with it. I've had to be off both Gleevec and Sprycel for extended periods due to side effect issues and have had no issues with regaining response. Of course, this isn't the best recourse, but it can be doable.

Wish I could give you more help! Hopefully Novartis will come through for you.

Pat


Pat

 

"You can't change the direction of the wind but you can adjust your sails."

DX 12/08; Gleevec 400mg; liver toxicity; Sprycel 100mg.; CCyR 4/10; MMR 8/10; Pleural Effusion 2/12; Sprycel 50mg. Maintaining MMR; 2/15 PCRU; 8/16 drifting in and out of undetected like a wave meeting the shore. Retired 12/23/2016! 18 months of PCRU, most recent at Mayo on 7/25/17 was negative at their new sensitivity reporting of 0.003.<p>


#3 Susan61

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Posted 25 September 2013 - 02:40 PM

Hi Tom:  Are you still out of work?  If you are out of work, then Novartis will help you.  They will give you a 90 day supply I believe.  They did it for me, but that was 5 years ago when my husband was out of work.  We were even on COBRA at the time, but they still helped me out.  They are getting a little tougher now about helping out.  They will make you fill out a form with lots of questions, and then let you know if you are eligible.

     The squeaky wheel gets the oil as they say.  Just keep asking for some help with whatever resources you can find.

Susan



#4 SunNsand

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Posted 25 September 2013 - 08:27 PM

Call Novartis and get your plan B started. They recently accepted me for financial help and I have insurance. (I'm underinsured) Novartis will fax the application to your Onc. office because he needs to fill in sections on it. I then went to my Onc's office to answer a few questions and signed my name. Their "financial person" filled out the paperwork and did all the faxing. With her help, it took me two wks to get my medicine.  In the past, their social worker helped but that position is now gone. Someone in your cancer center will help coordinate and they should make follow up calls as I did. It was her telling Novartis it was important to expedite the process. Good luck!






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