28 replies to this topic

[chriskuo]

Drug companies cannot/will not provide direct assistance to Medicare recipients.
They have an agreement with the Federal government to provide discounts through Medicare Part D plans.
That is why people on Part D don't pay full list price in the donut hole.

[chriskuo]

Gail's

Directing your anger at drug and insurance companies is pointless.
They are following the national policy set by our elected leaders.

LLS and other organizations with a clue are working with government and elected officials to improve drug and health care coverage.
You should do the same and join us.

[Gail's]

If your income is less than 500% of the federal poverty guidelines, then the LLS has a copay assistance program that will help with pharmacy copays.  Here's the maximum amount per year that they can help with:
 

• Chronic lymphocytic leukemia - assistance is available up to $2,500 (for applicants approved on or after 1/1/14)
• Chronic myeloid leukemia - assistance is available up to $7,500 (for applicants approved on or after 10/1/14)
• Lymphoma (Hodgkin and non-Hodgkin) - assistance is available up to $2,500 (for applicants approved on or after 1/1/14)
• Mantle cell lymphoma - assistance is available up to $5,000 (for applicants approved on or after 12/13/13)
• Myelodysplastic syndromes - assistance is available up to $5,000
• Myeloma - assistance is available up to $10,000

I don't know what kind of help Novartis gives to those who can't afford Gleevec.

Thanks for the info!

[Buzzm1]

Not going to get into the debate over obamacare because I think the anger should be aimed at the pharmaceutical companies and insurance companies. I have been a health care provider for more than 20 years but it took me very little time behind the scenes to realize those are the two biggest money makers related to health care.
My question is if anyone knows if the company producing gleevec would help pay your copayment for those who are on Medicare or private insurance.

 

Gail,

 

I contacted pattyzz, who posted regarding this subject on another thread, via email

 

Im going to be 65 in nov. Medicare co pay for Gleevec 400 mg is 2000.00 a month under part B. My part D plan is 2800.00 the first month and 475.00 the next months, which is still to high for me. Is anyone out there over 65 and taking the drug Gleevec? What do you pay? Can contact me at patzmail49@gmail.com.

 

 

 

asked: "Was wondering if you were able to find any way to reduce your Gleevec cost?"

received this back:

 

Yes, my Dr.'s office contacted manufacturer of Gleevec.  They have co pay assistance program.  We filled out forms and gave income info.  They have been giving me free pills  for 3mos. while they determine my eligibily.  But it looks like I will qualify, they just asked for proof im not getting any extra help from medicare, which im not.   Just waiting to hear back from Norvatis.   Then i will get my Gleevec delivered free for a year.   Then next year have to start process over again.  I read on internet that Gleevec is scheduled to go generic in feb. 2016.  Lets hope that will help.  Cancer drugs are so expensive once you loose you health ins. and have to go on medicare!  Thank you for your interest.   Good luck.   Check with Novartis 800  277 2254.  Their income requirement is generous.

 

Novartis has continually increased the price of Gleevec

from $3900/mo. in Oct. 2009, for 30 400mg tabs,

to somewhere around $9350/mo. now for 30 400mg tabs

[rcase13]

A lot of us on here have the Co-Pay assistance cards from the manufacturers. I am very happy to have it. Even after insurance covers the bulk of the cost there is still a lot left. I am very glad to have the card. It was also automatically renewed this year. I didn't have to do a thing.

 

I am too young to understand how Obama Care impacts medicare but I can tell you without the preexisting conditions being thrown out and the life time and yearly limits being thrown out I would be either dead or bankrupt. If they changing it I hope they don't lose those too things.

[chriskuo]

I would guess that copay assistance to people on Medicare is being directed through a non-profit, which the manufacturer may telling ng the patient about.  I have not found a manufacturer that will provide direct copay assistance to patient on Medicare.  The manufacturer programs are limited to patients with commercial insurance.

 

I t would be helpful if people on Medicare could post if and how they are getting copay assistance.

 

As mentioned in this thread, LLS may be an option for people under 500% of the poverty level.

[chriskuo]

rcase13,

 

One good thing about being younger is that the Medicare Part D donut hole will be gone by 2020.

 

I don't think any politician would be crazy enough to reinvent the donut hole.

[roamingdoc83]

Medicare, 'doughnut hole', Obamacare, assistance... dough. ouch.

I went without Gleevec for two years. No money, no coverage (was diagnosed while on Cobra, private insurance, b4 Ocare, came to nearly $1300/month for just me plus co-pays, etc, simply couldn't do it - obviously being on Cobra meant no job, sure people grasp).

Ultimately we had to sell our home, move out of CA, another state (lower cost of living), used my 401, made it to nearly Medicare time and have had 4 months of Novartis Assist program getting a bottle a month - Coming up on 6th year anniversary of diagnosis and still trying to make ends meet and now a 'darn' doughnut hole. Sounds like a 'black hole' sucking everything in...

BTW, for those arguing about insurance, so forth... our vaunted pols and the insurance companies could have allowed the 'free market' place to aid us all by allowing "all insurances" to sell across state lines but that is another story.

So right now NO ONE knows for sure if:

1. Novartis 'can' help medicare recipients with 'reduced' copay costs?

2. If 'some' medigap company has 'better services' than any other and aids copay issues?

3. Who will be the next pres? JUST kiddin'....

 

I will be looking forward to trying to see if there is a solution to paying for all this. Good thread, all stay frosty now.

Doc

[chriskuo]

Have you contacted LLS?

 

Under Medicare Part D, you will generally be responsible for the donut hole plus 5% of the additional cost (catastrophic phase coverage).

There may be some Medicare Advantage programs (possibly Kaiser) that would be more favorable by including drug coverage, rather than having to buy a separate Medicare Part D program.

 

Drug companies have a number of programs to help people under 65 with insurance (which now includes ACA marketplace).

For people over 65 who cannot afford their Medicare Part D copays, charitable support programs are important sources of support.

 

Some states have laws which have minimized the copays for oral chemotherapy drugs, but not all states have them.  These laws do not apply to Medicare, which is a Federal program.  Cross-state insurance is not likely to help with this problem.