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Could You Be Paying Less for Your MS Meds?

Posted on February 05, 2017
Getting the best deal for MS medication is rarely something we think about, especially if we have health insurance. However, there are deals to be had in the form of “copay assistance.” “Copay” is the amount of money we pay as consumers, or patients, out of our own pocket. It’s the part that is not covered by your insurance, and it can really add up. If you pay a copay, you may not need to. If you have commercial insurance with prescription coverage, it is likely that you qualify for $0 copays. Copay assistance programs are not income-based – so if you are paying any out-of-pocket costs for your MS therapies, you should contact the copay programs listed below!

"Teva has a program that will pay your copay. I called their 800 number and my medication is now 'free' to me, which is a huge help financially."
-MyMSTeam Member, Diagnosed with Relapsing/Remitting MS

Secret Shopper

We called the copay programs for the 13 different Multiple Sclerosis therapies listed below and found that a 10-minute phone call typically led to huge savings on out-of-pocket copays to pharmacies— that was a savings of hundreds, and in some cases thousands, of dollars per year.

  • EXAMPLE: You take Betaseron and have commercial insurance through your employer. Your pharmacy copay is $700/month. You call Betaseron and qualify for a $0 copay. You save $700/month because the copay assistance program pays up to $14,500/year in copays.

Here are the 13 hotlines we called and what they offer:

Aubagio

$0 copay program and your own dedicated nurse with a direct extension.

Visit Website 1-855-676-6326

Avonex

$0 copay program with no income requirements and no enrollment time limit. Free drug program for eligible patients in need.

Visit Website 1-800-456-2255

Betaseron

$0 copay program covers up to $14,500 in copay assistance each calendar year. Beta BRIDGE program covers the cost of medication while you are between insurance plans.

Visit Website 1-800-788-1467

Copaxone

$0 copay program with no paperwork required.

Visit Website 1-800-887-8100

Extavia

Copay program covers up to $600 each month and $7,200 each year. Patient assistance program provides free medicine to low-income, uninsured patients.

Visit Website 1-866-398-2842

Gilenya

$0 copay program and assistance with the cost of medical tests before you start the treatment.

Visit Website 1-800-445-3692

Glatopa

$0 copay program covers up to $9,000 per year.

Visit Website 1-855-452-8672

Lemtrada

$0 copay program and reimbursement up to $100 per day for charges related to the administration of your infusion.

Visit Website 1-855-676-6326

Ocrevus

$5 co-pay up to $20,000 per 12-month period for medication. Copay for infusion administration costs is $5 per infusion, up to a $500 daily limit, in each 12-month period.

Visit Website 1-844-627-3887

Plegridy

$0 copay program with no income requirements and no enrollment time limit. Free drug program for eligible patients in need.

Visit Website 1-800-456-2255

Rebif

$0 copay program if you have insurance or free medication program for one year if you are uninsured.

Visit Website 1-877-447-3243

Tecfidera

$0 copay program with no income requirements and no enrollment time limit. Free drug program for eligible patients in need.

Visit Website 1-800-456-2255

Tysabri

$0 copay program and infusion copay assistance up to $100 per infusion in certain states.

Visit Website 1-800-456-2255

Zinbryta

$0 copay program with no income requirements and no enrollment time limit. Free drug program for eligible patients in need.

Visit Website 1-800-456-2255

Each hotline can tell you if you are eligible for their $0 copay program (not needs-based) or some even have free medication programs for those in financial need. The phone specialists can also give you more information about need-based nonprofit programs or Medicare and other government coverage.

What’s In It For the Pharmaceutical Company? Why Do they Do This?
The process of calling was pleasant and the customer support people we talked to were more than happy to help us find out if we were eligible. The key point to understand is that the drug companies want you to be able to take the medication that helps you keep your symptoms at bay. In addition, they have a very real financial incentive to make sure you can afford your therapy. In order to get insurance plans to cover their drugs, the pharmaceutical companies need to prove that their MS drugs actually help you. If you can’t take your medication because you can’t afford it, then there is no way their drug is going to help you. So for them, helping you save on the cost of out-of-pocket expenses makes good business sense.

If you’re still not sure if you should bother picking up the phone, take a look at the simple scenario diagram below. If all signs point to “yes,” then pick up the phone!

Ready to call? Have these things ready:

  • ->Your prescription information
  • ->Your insurance card

Whatever happens, please come back to MyMSTeam and share with others the experience of whether it was worth the time to reduce your copay costs. Let us know how the process goes! We hope this is helpful to everyone on MyMSTeam!

----

At MyMSTeam we strive to share the best resources with our members -- especially resources that can help members who struggle with the cost of prescription drugs. MyMSTeam did not receive financial compensation or any other incentive to share this blog post with you.

A MyMSTeam Member said:

What type of grant? I’m looking for a cheap van with a lift. Out of my price range. Anyone know how to get one?

posted 7 months ago

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