5 replies to this topic

[katherinef]

For those on Medicare, how often do you have pcr testing?    I'm new to medicare and have been told that medicare will pay for 2 tests per year.   While on private insurance, I got the tests every 3 months.

I don't remember what the protocol is for someone pcru for many years.     I thought pcr testing was recommended every 3 mos -- but maybe it's now every 6 mos?

I'm going to follow up with my oncologist and I'm planning to phone medicare, but thought I'd ask here.

Thanks for any info -- best wishes to all.

Kathy

dx 03

[Trey]

The frequency of testing depends on how recently a patient was diagnosed, whether there are complicating factor (higher risk), how well the drugs are working, etc.  Some require PCRs every 3 months or less.

[MJL]

Hi Kathy, not to change the subject or your question but I have a question for you. How do you pay for your Gleevec on Medicare, or I guess I should ask, who pays for it? I have less than two years to go before I start on Medicare and it really does concern me. All this talk about the "do nut" hole and how seniors pay for thier medicines is very scary.

MJL.

[katherinef]

Hi MJL -- I'm happy to answer your question re Medicare.

With Medicare Part D in 2011 -- your out-of-pocket initial expense is $4550.   After that, you're in the catastrophic coverage and then pay 5% of the retail cost of gleevec -- or $200+ per month.    It's way too much money!

Thankfully, I did get help from the LLS as my income is low enough to qualify for the co-pay assistance of $5,000.    The CML money in the co-pay help program is depleted for now -- and I've heard that it may not be funded the next fiscal year.    Not good news and I hope it's incorrect.

Some states have plans to help those with lower incomes -- MA does and I'll get into that next year, assuming it's still around.

The donut hole will be phased out gradually, but I'm not entirely sure what all that means.    I think by 2020 it's gone -- but what that actually means to us, I don't know.    I hope it means good news -- though it's a long way off.

If you have any other questions, please ask.   Medicare is great for people who do not take pricey drugs -- but, for those of us who do, it stinks.   All the oral chemo drugs used to be 100% paid for under Medicare Part B -- but with the Bush admin's development of Medicare Part D, all these drugs got pushed into it and seniors/disabled got screwed.

I did find out, though, that Medicare does pay for however many PCR tests that our oncologists deem necessary.    This was my original question -- and it's important to me because I want to reduce my dosage and I want to be monitored closely.

Take care.

Kathy

[MJL]

Thank you so much for your prompt reply. It has eased my mind somewhat. Medicare is so difficult to understand sometimes and I was dreading the whole process. It's a big chunk out of pocket for us on expensive drugs. Lets hope the "Catastrophic coverage" will stay in place for those of us in need. I am recently widowed and living on Social Security and a small Annuity so my income is and will be low too. Let's also hope the funding stays in place too. When I get e mails from the LLS advocacy group I always send in my "Two cents worth". It is a great recource for staying on top of needed research and funding issues and letting the politicians know how we feel.

Again thank you.

MJL

[Cathy]

Hi, Well I have been wondering what medicare cost. I'm in my later 50's and wishing I could retire closer then its going to be if we have to pay $10 ,000. Off the top a year for our pills I'm on Sprycel so it would be $450 a month. and if  you still have a mortgage and your a one income family. Honestly it sounds pretty impossible to retire if you have cancer! Somehow that doesn't seem right. Maybe we need to move to the UK so our drugs might? LOL be paid for!

I"m glad I know but really how do you retire! I'll be working till I'm 70. And yes I have saved for retirement but taking that much off the top! I will have to work allot longer then I want to!

Have a good day all,