Aa
DMD Questions
Okay, these might sound like stupid questions but I am so worried about the financial ramifications of this disease.
1. When I get my DMDs will I get them filled at a regular pharmacy?
2. Do insurance companies usually fight with you on trying to pay for them since they are so expensive?
3. What is usually the cost of these meds? ( I am considering trying Rebif or Avonex) I have heard they run about $1500/month. I have to meet a $3000 deductible which means I may have to pay for my first dose. I don't have an extra $1500 floating around. I am really starting to freak out! But then again part of me figures I have probably had MS for 15-20 years an I am fine so far. I guess waiting another 1-2 months to start taking DMDs can't hurt. Can it?
Amy
1. When I get my DMDs will I get them filled at a regular pharmacy?
2. Do insurance companies usually fight with you on trying to pay for them since they are so expensive?
3. What is usually the cost of these meds? ( I am considering trying Rebif or Avonex) I have heard they run about $1500/month. I have to meet a $3000 deductible which means I may have to pay for my first dose. I don't have an extra $1500 floating around. I am really starting to freak out! But then again part of me figures I have probably had MS for 15-20 years an I am fine so far. I guess waiting another 1-2 months to start taking DMDs can't hurt. Can it?
Amy
Thank you Everyone! I am starting to feel a little better. I was worried that I was going to either have to delay my treatment or not pay certain bills or something worse. I was really scared. I feel like I can relax a little now.
Piece of cake getting it all done. Mine went through Perscription Solutions and Shared Solutions. Had a message from Shared Solutions before I even got home from my neurologist's office the day he dx me!
Co-pay is $35 per month (this is for copaxone) but PS has a program available for them to cover than part of the cost IF you open your medical file to them. I haven't done this.
Nurse comes out to show you how to inject. PS called every month to refill the perscription which is shipped UPS to my doorstep. Perscription was for 12 months so will need dr approval every year to continue.
Julie
Co-pay is $35 per month (this is for copaxone) but PS has a program available for them to cover than part of the cost IF you open your medical file to them. I haven't done this.
Nurse comes out to show you how to inject. PS called every month to refill the perscription which is shipped UPS to my doorstep. Perscription was for 12 months so will need dr approval every year to continue.
Julie
I started on the DMD's 20 Nov and it was pretty easy to get started.
I had my appointment with the Dr and I filled out a few pieces of paper and they sent that info and the percription to the drug company.
The drug company then contracted me and asked a few questions and then you talk to a finanical counselor to discuss your insurance and coverage. They do have some programs that will help with your copay.
I do get my rebif from Walgreens and only have a copay of 9.00. I decided on Walgreens instead of getting it by mail. I was worried about the side effects and did not want three months of rebif at one time just incase my body would reject it. I will eventually get it through the mail because my copay will be 9.00 for three months.
After everything was set with the meds the drup company called me to set up a time for the nurse to come to my house and show me how to give myself the shots. The first month my husband helped me with the shots but now I do them by myself. There is know reason to stree over everything because your doctor and the drug company try to make this very painless.
I hope I have helped with some of your questions.
I had my appointment with the Dr and I filled out a few pieces of paper and they sent that info and the percription to the drug company.
The drug company then contracted me and asked a few questions and then you talk to a finanical counselor to discuss your insurance and coverage. They do have some programs that will help with your copay.
I do get my rebif from Walgreens and only have a copay of 9.00. I decided on Walgreens instead of getting it by mail. I was worried about the side effects and did not want three months of rebif at one time just incase my body would reject it. I will eventually get it through the mail because my copay will be 9.00 for three months.
After everything was set with the meds the drup company called me to set up a time for the nurse to come to my house and show me how to give myself the shots. The first month my husband helped me with the shots but now I do them by myself. There is know reason to stree over everything because your doctor and the drug company try to make this very painless.
I hope I have helped with some of your questions.
There are no stupid questions.
Unless all your prescriptions fall under your deductible it should not count. Most of these Drugs go through Medco/Accredo pharmacy. Also who ever you go with Rebif for example will send a nurse out to teach you how to inject once you get the drug. It is not so bad.
Once it is all set up you will get calls from Rebif and Medco etc. It does take awhile.
Alex
Unless all your prescriptions fall under your deductible it should not count. Most of these Drugs go through Medco/Accredo pharmacy. Also who ever you go with Rebif for example will send a nurse out to teach you how to inject once you get the drug. It is not so bad.
Once it is all set up you will get calls from Rebif and Medco etc. It does take awhile.
Alex
here's the rebif contact information
http://www.rebif.com/pages/affordable-access/affordable_access
If betaseron would be of interest (another interferon) they have a ZERO dollar copay for all patients..........
http://www.betaseron.com/patients/about_betaseron/affording_betaseron.jsp
Good morning, your questions are not at all stupid. Let me give them a go....
1) the doctor will send the rx to the manufacturer's company that handles the drug you pick, along with the insurance information you have given to your neurologist. The drug company then contacts your insurance and determines the type of benefits you have and what your cost will be.
The drug company will then contact you to finalize the deal. Almost all insurance companies have specific specialty pharmacies that stock these DMD's. It is not something you can get at CVS or Walgreens.
Once everything is set up, the specialty pharmacy will be in contact with you to arrange the first delivery. Almost everyone gets them delivered to their home .
It really is a fairly simple process once you get through the first or second shipment.
2) Insurance companies do not fight these drugs - in the long wrong they will ultimately save the insurance company money if they keep you healthier than without the drug. If you are dx'd your insurance cannot withhold these drugs from you.
3) the monthly cost varies according to the insurance. All of these drugs have patient assistance programs to help with the cost. That may be a factor for you as well- I'm thinking that maybe REbif has a monthly $50 copay max for patients with private insurance. You can always call them and talk to them about their program before you make your final decision.
You are so right - another 1-2 months won't make much of a difference. Good luck with this next step,
Lulu
1) the doctor will send the rx to the manufacturer's company that handles the drug you pick, along with the insurance information you have given to your neurologist. The drug company then contacts your insurance and determines the type of benefits you have and what your cost will be.
The drug company will then contact you to finalize the deal. Almost all insurance companies have specific specialty pharmacies that stock these DMD's. It is not something you can get at CVS or Walgreens.
Once everything is set up, the specialty pharmacy will be in contact with you to arrange the first delivery. Almost everyone gets them delivered to their home .
It really is a fairly simple process once you get through the first or second shipment.
2) Insurance companies do not fight these drugs - in the long wrong they will ultimately save the insurance company money if they keep you healthier than without the drug. If you are dx'd your insurance cannot withhold these drugs from you.
3) the monthly cost varies according to the insurance. All of these drugs have patient assistance programs to help with the cost. That may be a factor for you as well- I'm thinking that maybe REbif has a monthly $50 copay max for patients with private insurance. You can always call them and talk to them about their program before you make your final decision.
You are so right - another 1-2 months won't make much of a difference. Good luck with this next step,
Lulu
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