Forums
6 posts
• Page 1 of 1
Going on Medicare next year now what?
I was diagnosed with Multiple Myeloma in August of 2011 I got treatment starting in October of 2011 of Revlimid and Dexamethasone till Jan 2012. I got a stem cell transplant on May 2nd I am now on Maint of Revlimid and Dexamethasone all has been covered under my wifes PPO Blue policy. I am on SSD as of March 2011 due to my disease. I will automatically go on medicare next year. I am reading that Medicare does not want to pay for Revlimid? What Am I supposed to do now? What type of Part D coverage should I get? Where can I find out what to do to get covered now? Is there anything I can do to get coverage that will pay? BTW I am 62 but since I am on SSD I automatically go on medicare after 2 years.
-
genk - Name: Ed
- Who do you know with myeloma?: myself
- When were you/they diagnosed?: August 2011
- Age at diagnosis: 61
Re: Going on Medicare next year now what?
Hi,
My husband was approved for SSDI because he has a very debilitating case of myeloma and has been unable to continue to work. After 2 years on SSDI Social Security kicked in. We found it better to stay on our private insurance and only take part A because Medicare does not pay for stem cell storage and when I checked into Medicare drug plans it seamed that we would pay more for a drug plan that covered the expensive myeloma drugs ( like Revlimid) than we would to continue paying for our private insurance. It's been really expensive but at least the whole family is covered and our family deductible is covered by my husband's illness. I would like to know how other people pay for these drugs, and what about the clinical trial drugs, how is that handled with medicare? I was told that a Medicare Supplement policy will only cover things that Medicare covers, which is less than our private insurance( my husband had one stem cell transplant and has cells stored for another if he needs it) I'm hoping with the new healthcare law there will be more options for people with pre-existing conditions.
My husband was approved for SSDI because he has a very debilitating case of myeloma and has been unable to continue to work. After 2 years on SSDI Social Security kicked in. We found it better to stay on our private insurance and only take part A because Medicare does not pay for stem cell storage and when I checked into Medicare drug plans it seamed that we would pay more for a drug plan that covered the expensive myeloma drugs ( like Revlimid) than we would to continue paying for our private insurance. It's been really expensive but at least the whole family is covered and our family deductible is covered by my husband's illness. I would like to know how other people pay for these drugs, and what about the clinical trial drugs, how is that handled with medicare? I was told that a Medicare Supplement policy will only cover things that Medicare covers, which is less than our private insurance( my husband had one stem cell transplant and has cells stored for another if he needs it) I'm hoping with the new healthcare law there will be more options for people with pre-existing conditions.
-
Jade
Re: Going on Medicare next year now what?
I am a California resident. I'm not sure if this will help you but thought I'd give some advice. My husband is 36 and was diagnosed about 3yrs ago with multiple myeloma. He is now on SSI. He was covered under Kaiser at the time of his diagnosis. It expired this year. We had to choose either Medicare part B & D (Medicare is free for part A-which became effective last yr) or pay full price to continue on Kaiser coverage. I called Medicare, back in December, when we knew his coverage was going to be up and asked them if Revlimid, Dexamethasone, Dilaudid were covered. Revlimid and Dexa are the 2 he's been taking for the past year and dilaudid as needed. All I remember it was an outrageous price. I believe it was about $2000 plus for just the Revlimid. We declined the Medicare part D and part B. We stayed with Kaiser and pays full price. The price is $519 a month & copays are $10 for generic and $20 for non generic, specialist are $30 copays. We spend about $100 or so on meds monthly because he's a diabetic too. Total monthly cost about $650-$700. This may be high but alot cheaper than what out-of-pocket would be thru Medicare. It has been a struggle and we had to restructure our lives COMPLETELY in order to survive. . O by the way, there's a financial assistance program for copays that will reimburse you copays. We have enrolled for the past 2 yrs and has worked. It's called co-pay relief. Good luck and God Bless
Re: Going on Medicare next year now what?
I live in Tennessee and my doctor told me to get in touch with cel gene to see if they had any grants that were available . I did receive a grant for 10,000.00 a year to pay company's.Good luck and God Bless.
-
Butter
Re: Going on Medicare next year now what?
genk wrote:
> I was diagnosed with Multiple Myeloma in August of 2011 I got treatment
> starting in October of 2011 of Revlimid and Dexamethasone till Jan 2012. I
> got a stem cell transplant on May 2nd I am now on Maint of Revlimid and
> Dexamethasone all has been covered under my wifes PPO Blue policy. I am on
> SSD as of March 2011 due to my disease. I will automatically go on medicare
> next year. I am reading that Medicare does not want to pay for Revlimid?
> What Am I supposed to do now? What type of Part D coverage should I get?
> Where can I find out what to do to get covered now? Is there anything I
> can do to get coverage that will pay? BTW I am 62 but since I am on SSD I
> automatically go on medicare after 2 years.
My wife's situation mirrors yours in almost every respect (age, insurance,etc). I can tell you what we did. First, medicare part A,B doesn't cover Revlimid, that's under part D. (Note that this may change in the next year or 2) Since her prescription list rivaled our local Walmart pharmacy shelf, we elected to get the best Part D (AARP) coverage we could. This choice was made easier by the fact that her ex-employer pays the premiums for part D. That being said, there wasn't a whole lot of difference in cost between the cheapest and most expensive part D choices: they are both ridiculous. Medicare has a website where you can estimate your drug costs under part D options available to you. It is crucial IMHO to get financial aid. The qualifications are liberal for many programs. The 2 we've had the most luck with are the Leukemia & Lymphoma Society and the chronic disease fund. Between these 2, we've reduced our out of pocket costs by 90%.
Send me a private message if you want more info.
Good luck.
> I was diagnosed with Multiple Myeloma in August of 2011 I got treatment
> starting in October of 2011 of Revlimid and Dexamethasone till Jan 2012. I
> got a stem cell transplant on May 2nd I am now on Maint of Revlimid and
> Dexamethasone all has been covered under my wifes PPO Blue policy. I am on
> SSD as of March 2011 due to my disease. I will automatically go on medicare
> next year. I am reading that Medicare does not want to pay for Revlimid?
> What Am I supposed to do now? What type of Part D coverage should I get?
> Where can I find out what to do to get covered now? Is there anything I
> can do to get coverage that will pay? BTW I am 62 but since I am on SSD I
> automatically go on medicare after 2 years.
My wife's situation mirrors yours in almost every respect (age, insurance,etc). I can tell you what we did. First, medicare part A,B doesn't cover Revlimid, that's under part D. (Note that this may change in the next year or 2) Since her prescription list rivaled our local Walmart pharmacy shelf, we elected to get the best Part D (AARP) coverage we could. This choice was made easier by the fact that her ex-employer pays the premiums for part D. That being said, there wasn't a whole lot of difference in cost between the cheapest and most expensive part D choices: they are both ridiculous. Medicare has a website where you can estimate your drug costs under part D options available to you. It is crucial IMHO to get financial aid. The qualifications are liberal for many programs. The 2 we've had the most luck with are the Leukemia & Lymphoma Society and the chronic disease fund. Between these 2, we've reduced our out of pocket costs by 90%.
Send me a private message if you want more info.
Good luck.
-
zephyrus - Name: Lee
- Who do you know with myeloma?: wife
- When were you/they diagnosed?: Feb, 2012
- Age at diagnosis: 64
Re: Going on Medicare next year now what?
So, I was talking to my financial planner today (who also knows a bit about health insurance) about my disease, and he suggested that I look into "Medicare Plus". I know nothing about this as I'm still a few years off from having Medicare as an option and I'm currently on group insurance, but it sounded like it was a marriage of private insurance and medicare that may offer you more options and potentially better prices on the drugs??? Again, not speaking from any experience here.
-
Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
6 posts
• Page 1 of 1
Return to Insurance & Patient Assistance Programs