Rebif medicare

Common Questions and Answers about Rebif medicare

rebif

The medications I currently take for MS (including Rebif, Ampyra, etc.), are NOT covered on any Medicare Prescription Drug Plan? Between Rebif and Ampyra, the out of pocket costs for a year of medicines in over $52,000 [The moneys my wife & I receive from Social Security Disability is only about $24,000, in a year] Are any of you, in this position, and if so, what are you doing about it?
I have been taking Rebif injections, since January 2010, and I have never missed a single one, until now. Up until January 1, 2012, I have received my Rebif injections, free of charge, due to the fact I had no health insurance. I became eligible for Medicare, on January 1, 2012, and so I have had to wait for MS Lifelines to decide whether I'm still eligible for their "free of charge" program.
), I go on Medicare with my insurance becoming my secondary insurance. It was the year mark so my neuro gave me a dx. It is Progressive Relapsing MS. I half listened but I knew from her voice it wasn't a very nice one to have...So true to my nature, I half listened nodding with "okay's" and "yes I understand". Then I left the office and finally decided to understand it having my husband explain last night. Not satisfied I googled it. It doesn't sound too bad but.......
I applied for SocialSecurity Benifits since i can not afford all these scripts and MRI's w Medicaid. Not even able to get the rebif yet, which i NEED. Will they approve me for that, since i am not at all able to work?
Do to the lack of funds for the Chronic Disease Fund, I won't be able to get my meds(Rebif). I am 68, Medicare will help but I'll pay $1230 til I reach the deductible, after that $1021 til coverage gap then $1765 til catastrophic. This is monthly. I can eat up our savings, yes. Then I'll be eligible for aid because we'll be in the right income level. POOR! So this is just to tell you, thank you for all the info & hope you supply to the young people afflicted.
Ironically my having to cut out my MS treatment is tied to Medicare and Medicaid. Whenever the reimbursements to providers is cut for Medicare and Medicaid the cost is shifted on to me with private insurance by the Hospital. Otherwise these institutions would not see Medicare or Medicaid patients at all. Say a MRI costs $2000 at my Hospital. Medicare pays $1000, I am charged over $3000 for the same test. I pay over $1000 out of pocket to make up what the hospital lost on the Medicare patient.
They will accept what the insurance gives, and will not expect any more from the patient. The nurse said, the rest of the injectables will follow (Copaxone, Rebif, Avonex). They "always" follow each other to stay competitive. That is a GREAT thing.I hope she was/is right.
However, I was also told, I have to wait 2 years from acceptability to get Medicare, for me that's two years from January or January 2012. In the meantime, no medical/health insurance. Therefore any follow-up visits with my Neurologist, will be completely "out-of-pocket", and no he doesn't give discounts (because I have no medical insurance). It also means, I cannot go to see any medical doctor, Primary Care, etc.
This is already the situation for me and my Medicare coverage, so be prepared if you are going onto Social Security Disability Income and then Medicare. I have to pay $4000 out of pocket before going to 10% of my (now $1715 Avonex). Right now I am in my "donut hole" where Medicare doesn't pay a thing. Our legislators really screwed us with the Medicare Drug deal!
The one limitation is that your insurance cannot be via the government (like Medicare etc). I'll also say that I've been on Rebif for 18 months with no flu-like symptoms or other bad effects, and no relapses -- but everyone is different. (I know this sounds like a commercial for Rebif -- it's really not -- but if it turns out that you need another option, might be helpful info) Worth looking into, if Gilenya doesn't work for you.
Alex, I believe Rebif has gone to a no copay for life, program. But I don't know what their fine print reads, especially if you are on medicaid or any other government assistance. Have you talked with a case worker at SS or just the telephone answerers?
Those on private insurance subsidize those on on Medicare and Medicaid. As the government cuts provider compensation the providers pass that on to the patients not on government programs. Say an MRI costs $2,000. The government pays the Hospital a $1,000 for someone on Medicare. I get charged $3,500 for the same MRI. I have to pay $1,500 out of pocket and my insurance pays $2,000. I have one more payment on that MRI from last August. The Government is cutting providers more as we speak.
Because I am on Social Security Disability I am on Medicare. My out-of-pocket cost for my Avonex is about $4500 a year. But on top of that I have the Provigil and the Clonazapam which adds another $500 a year.
In 2009 the fee for people with a Medicare card is $32.90. The fee is $5.30 for people with a Medicare card and a pension or concession card. Further information about the PBS and your entitlements can be viewed on the Medicare Australia website at: www.medicare.gov.au I have a pension card so pay $5.30 for any prescription drug.......
Are you on any of the disease modifying meds(rebif,copaxone,avonex)? There are meds that can help with the burning sensation such as lyrica and neurontin. I've been on the solu-medrol infusions 3 times since march,they definately help with the attacks but not all my symptoms disapated.But we are all different.If the burning sensation worsens call your neuro.
He is bright, very involved in meetings, conferences, and research. After 10 1/2 years I've taken Copaxone, Rebif, Mitoxantrone, Tysabri and Ampyra. Aside from the last two which I'm certain are working, neither of us knows if C/R/M helped in the least. They could have slowed progression, but there's no way to know. Suzie, in reference to if he has PRMS, or RRMS, the lines are blurry, and some drs.
37 for 30 pills, a months supply. The other two Rx, he currently has me taking (Rebif and Ampyra, the companies that provide me with them, provide them for no cost to me). I know, he wants to be able to do more, for me, but w/o medical / health insurance, his hands are tied, as are mine. I can say, that I was blessed, in that he actually seemed to listen to me more this time, than any other, so far, which does help, if you know what I mean.
I have no health insurance, and am on Social Security Disability, I was awarded it, in May, but retroactive to January 2010. Since, I was awarded it, I am eligible for Medicare, but not until January 2012 (you have a two year waiting period). I also had filed for Medicaid, which is suppose to help with health care coverage until Medicare takes over. I wasn't told I was awarded it (until this month), no confirmation letter and no Medicaid cards, etc.
more than medicare says, you don't have to pay and can file a dispute with medicare...... I had problems for about 6 months and neuro and I worked thru each of them and my last year have not had any problems with side effects. Your fatigue could be caused by MS Tysabri does not do away with the little nuisance problems, only help protect against future flares........sometimes its common to have flares the first year til it really kicks in........I can tell now that my flares are slowing down.
I can't think of any drugs right now for MS (hopefully oral ones come out soon) that will help with slowing down (or possible haulting) the disease progression that are cheaper. You may want to infer on the cost of Rebif, Avonex, and Betaseron with your insurance company. You may also want to contact MS Lifelines (for Rebif), Avonex (I think its MSActiveConnect), and BetaPlus (for Betaseron), too, to see if there's something they can do to defray costs.
I am on Medicare and had no problem. The test is not done routinely, but should be run if there is a suspicion that a medication has stopped working. So, if the person is having more relapses than before or the MRI is looking much worse, then that would be an indication to run the test. For Avonex it is unusual to develop neutralizing antibodies before you have been on the med a full year. A neutralizing antibody is an antibody that our own immune system can make.
I don't know what to think. I started on Rebif when I was Dx'd and the site reactions were so bad I switched to Betaseron. The Beta worked well for a while then I started getting reactions from that too. My Dr thought about switching to copaxone but if every other day injections were bad enough then every day injections are probably not a good idea. My MRI's have not changed the entire time I have been on DMD's, but my condition has deteriorated greatly over these last 2 years.
he gave me a bunch of bullsh-- about how medicare expects them to mark up the price of the drugs and if they don't that they can't afford to stay in business and that they contract with companies blah blah blah blah I waited TWO HOURS in his waiting room to get that news from him. I was in tears in the office. I felt like I desperately needed this drug and that I had no way of affording it. He called me two days later and said he couldn't lower the cost.
I'm thinking I have heard some express that copax is not as potent as the interferons. My neuro describes the difference between the interferons (betaseron, rebif and avonex) and glatiramer acetate( copaxone) as similar to a pepsi/coke challenge. they are all the same, it just depends on personal preference as to which one you like better. Is your doctor offering you copaxoneThe side effects we know from copaxone, after 18 years of use, is the lipotrophy. Period.
Carol, I take Ampyra, and have been for a few months now, and like my Rebif, I'm blessed that I can take it, at no cost to me (well, and that's because I don't have any insurance, right now). However, what it's for, I can't remember, is it for your "gate"?
we were on NORD assistance and when hubby got on ss disability we were kicked off we cant afford medicare insurance and so we do have medicare rx but they wont cover hardly anything of copaxone. I have tried everywhere and most insurance companies rates are way too expensive for us. we are just barely above poverty level. I havent tried the teva maybe they can help. Our cost right now will be$1750 per month then medicare will only cover the 750.
he gave me a bunch of bullsh-- about how medicare expects them to mark up the price of the drugs and if they don't that they can't afford to stay in business and that they contract with companies blah blah blah blah I waited TWO HOURS in his waiting room to get that news from him. I was in tears in the office. I felt like I desperately needed this drug and that I had no way of affording it. He called me two days later and said he couldn't lower the cost.
My situation is different because I am on Medicare. But, the pharmacy that my Medicare Advantge plan uses does send my Avonex to me via FedEx. My MS Doc who is also an MS researcher said the same thing about himself and his family about Avonex. He isn't a fan of Copaxone. I'd ask him why, but he doesn't take questions from me very well. I don't think he is comfortable with my being a physician. He gets defensive like my questions are criticizing him.
To make it short we left there with no diagnosis and no money. Finally in June of 2007 my medicare started. I had an appointment on June 1st with a neurologist. We went over there with every test, film, and medical record that we could get our hands on. After a couple of weeks for her to go over everything and get new MRI's to compare plus order a couple of more test, she diagnosed me with MS. She has spent the last 2 weeks trying to get a hold of my doc.
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