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Question Re: Ocrevus Infusion On Medicare Advantage Plan

Question Re: Ocrevus Infusion On Medicare Advantage Plan

I just started receiving disability this month & received my Medicare card. Will be on a Medicare Advantage Plan as of June 1st. My shots for Copaxone or the generic even with the plan will cost me 33% which is not feasible at all. My other option is my doctor said he has had much success with patients and Ocrevus. My Advantage plan said that since it is an infusion in a hospital setting part of it gets charged to each Part A and B and i would have to pay out of pocket co-pay $345 each visit. I… read more

A MyMSTeam Member said:

@A MyMSTeam Member I would consider reaching out to the National Ms Society to see if they can offer any recommendations if you cannot find a solid answer on this site.

posted 5 days ago
A MyMSTeam Member said:

Depending on your advantage plan some pay infusion under part B which mine did for my tysabri and I received a grant that would pay the 20% required copay for part B expenses and that usually paid my maximum $5500 for the year by March which was nice but starting this year Humana advantage changed tysabri to part D but I applied for medically needy with Medicaid and applied for extra help so out of pocket is only $9.95 but since it’s a top tier drug after meeting Medicare catastrophic levels I pay nothing for the drug but $26 a month for act of infusion. Apply for everything because you never know what you’ll qualify for. Don’t bother trying to under it just apply. Nothing ventured nothing gained.

posted about 16 hours ago
A MyMSTeam Member said:

Here is the link to the program offered by Ocrevus: https://www.ocrevus-hcp.com/resources/financial...

The do have co-pay Assistance even for people on public insurance (Medicare or Medicaid). In my experience, these co-pay assistance programs pay most if not all of the co-pay for someone on SSDI. It looks like with this one, you would likely have a co-pay of $5.

The MS Society can help you navigate options as well. I am very fortunate to have a neurologist (who also has an excellent MA) who looks into these things for me and has all the info on hand.

posted 5 days ago
A MyMSTeam Member said:

This is so frustrating bc the hospitals are grabbing money from innocent people to cover their costs and losses elsewhere 😒I worked with some extraordinary Dr's b4 I became too ill to work. I also learned a lot from med school and dealing 1st hand with the drug reps and pharmaceutical companies. Ask to speak to the patient advocate. Maybe they have someone with knowledge of the Patient Assistance Program with medication. IT DOES NOT MATTER IF THE MED IS PAID BY FEDERAL FUNDS OR PRIVATE INSURANCE. That is discrimination. If ur Dr's office doesn't have someone who knows about the patient Assistance program find out the name of the company that makes the drug and contact them. They have applications for medical Assistance to pay 100% of the medical costs. You can have them fax you the application,fill it out and have your doctor sign it. Once signed,fax it back to the company and get the name;date and time of the person who received the fax for your personal records. Hospital administration really disgust me 99.9% of the time. And don't get me started on CPT coding and BILLING!!! UGH! Anyway,hopefully this will help you please let me know how it goes!

posted 5 days ago
A MyMSTeam Member said:

(they ALL have one. find out who it is for whatever you are getting!)

posted 5 days ago
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