Hi I'm new to this site. My history - I was diagnosed with non-Hodgkins lymphoma in August of 2003 and 6 months later I was diagnosed with multiple myeloma. My M spike was so high my doctor put me into the hospital to begin 4 rounds of VAD in preparation for a stem cell transplant, which I had in October 2004.
I was in remission for about 2 years and then multiple myeloma reared its ugly head again. I had several treatments - Velcade, carfilzomib [Kyprolis], and then about 5 years ago my doctor put me on Revlimid. I started out at 20 mg with dex and now I'm down to 5 mg without a steroid.
I retired from JPMorgan Chase in December 2003 and qualified for retiree medical benefits. I've been paying a $100 per month copay for Revlimid. JP Morgan has just announced that they are doing away with the group plan and they have hired consultants to help us find new individual plans. I'm really worried as I know how expensive Revlimid is.
I have Medicare so I now have to find Medigap and Part D plans to cover my expenses. I live in NYC. Does anyone have any suggestions for Part D plans that would give me good coverage? I also have high medical expenses - I have an IVIG infusion monthly due to my suppressed immune system, plus mo blood tests, etc.
Thanks for any help you can provide.
Moderator's note: This posting originally was posted in the discussion about Revlimid's cost that is here in the forum. We thought it might be better, however, if it had a thread of its own due to the questions Prshiells has asked.
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Re: Diagnosed in 2004, worried about Revlimid cost
This link might help.
"Part D drug plan recommendations + experiences?", Beacon forum discussion started January 15, 2014.
"Part D drug plan recommendations + experiences?", Beacon forum discussion started January 15, 2014.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Diagnosed in 2004, worried about Revlimid cost
Because the insurance companies that provide supplemental and Part D coverage vary from state to state, I can't give you specifics for New York. I live in Pennsylvania and decided on AARP Plan F supplemental.
Plan F is a little more expensive than the lower letter plans, but it pays 100% of most of the costs that Medicare Part B doesn't pay. So, there are no co-pays and no co-insurances to pay. It also has some coverage for foreign travel if you should get sick while out of the country. This is important to me. This plan also makes it so that I can budget better for the year.
Part D plans can vary widely in coverage and expense. The co-pay amount for non-formulary or level V drugs varies from 25% to 40%. I chose AARP Part D, the least expensive of the 3 plans that they offer. I did this after talking with a representative who told me that, with the cost of the Revlimid, I would be in and out of the donut hole and into catastrophic coverage within one month of Revlimid. So, there was no need to get the more expensive plans which would have lower co-pays during the first $2000+ of part D coverage.
The first prescription in the year is around $4500 and then around $450 each prescription after that. I applied for a grant from the Chronic Disease Fund to pay for my Revlimid and qualified for a $10,000 grant. I also applied for a grant from the LLS and qualified for a grant that pays my Part B, supplemental and Part D costs per year.
It's important to look at all of the details of the various plans available in your area. All of the supplemental plans provide the same coverage for the different levels, but may also add some things that aren't listed. Part B and supplemental would probably be responsible for the IVIG, so you would need to specifically ask about that.
Go on line to the Medicare website and get the basics and then call the different companies you are interested in to ask your specific questions. It takes a lot of time and can be confusing, but it is worth it. Talk with the social worker where you are being treated to see if s/he can help with some basics. See if there are any seminars in the next couple of months about insurance for people with cancer. I went to one a year before I was eligible for Medicare and it really helped me to formulate what my needs would be.
Good luck finding what works the best for you,
Nancy in Phila
Plan F is a little more expensive than the lower letter plans, but it pays 100% of most of the costs that Medicare Part B doesn't pay. So, there are no co-pays and no co-insurances to pay. It also has some coverage for foreign travel if you should get sick while out of the country. This is important to me. This plan also makes it so that I can budget better for the year.
Part D plans can vary widely in coverage and expense. The co-pay amount for non-formulary or level V drugs varies from 25% to 40%. I chose AARP Part D, the least expensive of the 3 plans that they offer. I did this after talking with a representative who told me that, with the cost of the Revlimid, I would be in and out of the donut hole and into catastrophic coverage within one month of Revlimid. So, there was no need to get the more expensive plans which would have lower co-pays during the first $2000+ of part D coverage.
The first prescription in the year is around $4500 and then around $450 each prescription after that. I applied for a grant from the Chronic Disease Fund to pay for my Revlimid and qualified for a $10,000 grant. I also applied for a grant from the LLS and qualified for a grant that pays my Part B, supplemental and Part D costs per year.
It's important to look at all of the details of the various plans available in your area. All of the supplemental plans provide the same coverage for the different levels, but may also add some things that aren't listed. Part B and supplemental would probably be responsible for the IVIG, so you would need to specifically ask about that.
Go on line to the Medicare website and get the basics and then call the different companies you are interested in to ask your specific questions. It takes a lot of time and can be confusing, but it is worth it. Talk with the social worker where you are being treated to see if s/he can help with some basics. See if there are any seminars in the next couple of months about insurance for people with cancer. I went to one a year before I was eligible for Medicare and it really helped me to formulate what my needs would be.
Good luck finding what works the best for you,
Nancy in Phila
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NStewart - Name: Nancy Stewart
- Who do you know with myeloma?: self
- When were you/they diagnosed?: 3/08
- Age at diagnosis: 60
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