Aa
LimboLander,All Ins.Info IMPORTANT
Its a huge and confusing thing when your in limboland, but when you start to approach the time of getting a diagnosis, whether it be MS, or A Mimic Disease, things can get hugely overwhelming and the cog and fog can really set in, and because of all the stress and confusion, it is easy to over look or forget, that you should first get very acquainted with your medical insurance coverage. Because if and when you get a diagnosis of MS or other demylinating disease your insurance will be playing a huge role in paying for the types of medications you may need. And you care etc..
First off just an example If you end up with a diagnosis of MS, the first thing the doctors will want to do is get you started on one of the progression slowing injection drugs, such as copaxone or rebif just to name a couple.
I just got done choosing the copaxone (just seems right for me). But It is going to cost my insurance company $1769.00 per month = a 30 day supply. (my co pay will be $40.00 per month) No joke- I repeat 1769.00 for each month. And that is because i use one of their in network pharmacies. (otherwise the customary charge would be $2096.00 per month.
Now remember, that is just for helping to slow the disease progression progress. Now consider also that down the road with your MS that at some point in time you may be prescribed, other medications to help relieve pain and other symptoms of MS. which will add to you co-pays as well.
So here is the sticky part to look for while reviewing your coverage (especially the drug coverage of you plan)
Check to see if you have Catastrophic Coverage with a Coverage Gap on Drugs.
Coverage gaps can include cut off
amounts where they will only pay (for example only)
up too oh say $2500.00 between what they pay and what you pay for co pays would be applied to that 2500.00 limit for the year. That would be considered your initial coverage period.
now next this is where you would go into a coverage gap period, MEANING- you would have to pay 100% of your Drug Costs until you reach their Catastrophic coverage level.meaning that if their catastrophic coverage starts at $4000.00 you will have to pay another 4000.00 out of your own pocket and then when you have done that they will start to pay most of or all your perscriptions after that for the rest of the year. The following year it starts all over again.
For limbolanders not that you probably haven't check out and studied your insurance, and know the basics and all, but it might be providing well enough for you at this time, but what if you get Dx's with MS and need all this horribly expensive treatment.
This is what I did before my Dx i found out and explored what drugs i may have to be getting on a long term or forever basis, and what drugs alot of people on the forms are using ect. then, I checked all of them in my medical insurance book to see what tiers and co pays if they even cover some of them. (just in case I may need to use them in the future). I went to drug co. sites checking the prices per month that they charge so I could be aware of what my insurance company would be paying on their part.
Limbolanders, check this out especially coverage gaps with catastrophic coverage, every insurance company has different rules on it.SO KNOW YOUR COVERAGE .....ask questions!
this way you can be prepared if you think you may have to shop around for a better plan that covers more. Trust me you don't want to run into a problem when you doctors are ordering injections that for a 30 day supply cost 2000.00 .
YOU WILL NOT WANT TO HAVE TO DEAL WITH THAT KIND OF A MESS AT THE TIME OF A DIAGNOSIS, THE DIAGNOSIS ALONE IS ENOUGH TO DEAL WITH, SO STUDY UP BEFORE HAND NOT JUST THE MS DRUGS ECT, BUT SOME OF THE MIMIC DISEASES AS WELL IF YOU THINK YOU DOCTOR IS LOOKING IN THAT DIRECTION.
I CALL IT PEACE OF MIND. SORRY SO LONG BUT SO IMPORTANT. ALL MY BEST TO EVERY ONE. GOLLIE
First off just an example If you end up with a diagnosis of MS, the first thing the doctors will want to do is get you started on one of the progression slowing injection drugs, such as copaxone or rebif just to name a couple.
I just got done choosing the copaxone (just seems right for me). But It is going to cost my insurance company $1769.00 per month = a 30 day supply. (my co pay will be $40.00 per month) No joke- I repeat 1769.00 for each month. And that is because i use one of their in network pharmacies. (otherwise the customary charge would be $2096.00 per month.
Now remember, that is just for helping to slow the disease progression progress. Now consider also that down the road with your MS that at some point in time you may be prescribed, other medications to help relieve pain and other symptoms of MS. which will add to you co-pays as well.
So here is the sticky part to look for while reviewing your coverage (especially the drug coverage of you plan)
Check to see if you have Catastrophic Coverage with a Coverage Gap on Drugs.
Coverage gaps can include cut off
amounts where they will only pay (for example only)
up too oh say $2500.00 between what they pay and what you pay for co pays would be applied to that 2500.00 limit for the year. That would be considered your initial coverage period.
now next this is where you would go into a coverage gap period, MEANING- you would have to pay 100% of your Drug Costs until you reach their Catastrophic coverage level.meaning that if their catastrophic coverage starts at $4000.00 you will have to pay another 4000.00 out of your own pocket and then when you have done that they will start to pay most of or all your perscriptions after that for the rest of the year. The following year it starts all over again.
For limbolanders not that you probably haven't check out and studied your insurance, and know the basics and all, but it might be providing well enough for you at this time, but what if you get Dx's with MS and need all this horribly expensive treatment.
This is what I did before my Dx i found out and explored what drugs i may have to be getting on a long term or forever basis, and what drugs alot of people on the forms are using ect. then, I checked all of them in my medical insurance book to see what tiers and co pays if they even cover some of them. (just in case I may need to use them in the future). I went to drug co. sites checking the prices per month that they charge so I could be aware of what my insurance company would be paying on their part.
Limbolanders, check this out especially coverage gaps with catastrophic coverage, every insurance company has different rules on it.SO KNOW YOUR COVERAGE .....ask questions!
this way you can be prepared if you think you may have to shop around for a better plan that covers more. Trust me you don't want to run into a problem when you doctors are ordering injections that for a 30 day supply cost 2000.00 .
YOU WILL NOT WANT TO HAVE TO DEAL WITH THAT KIND OF A MESS AT THE TIME OF A DIAGNOSIS, THE DIAGNOSIS ALONE IS ENOUGH TO DEAL WITH, SO STUDY UP BEFORE HAND NOT JUST THE MS DRUGS ECT, BUT SOME OF THE MIMIC DISEASES AS WELL IF YOU THINK YOU DOCTOR IS LOOKING IN THAT DIRECTION.
I CALL IT PEACE OF MIND. SORRY SO LONG BUT SO IMPORTANT. ALL MY BEST TO EVERY ONE. GOLLIE
Drug Company assistance is not necessarily easy to get or guaranteed. I am not sure about them paying for the DMD if you do not have insurance in the U.S.. Usually they only help with Copays. That would be too expensive a tab for them $24,000 a year.
I started my Copaxone a little over a month ago. All seemed fine at first but now I seem to get more welts and brusing then before. The initial shot really stings but settles after a few minutes. The welts seem like large mosquito bites and they do itch sometimes. Does this sound normal? Other then the bruising and welts i feel fine.
Lorrie
Lorrie
Hi there thanks for posting, i cant wait to get my guchie tote and auto injector lol.
In all seriousness, as soon as I put the meds in the fridge and closed the door that is when everything started to sink in very hard. I will post on it as well ill be looking forward to reading your. Be well Gollie
In all seriousness, as soon as I put the meds in the fridge and closed the door that is when everything started to sink in very hard. I will post on it as well ill be looking forward to reading your. Be well Gollie
I just started Copaxone a little over a month ago....if either of you have any questions or just need someone to go through this with.... I AM HERE for you both.
Except for some injection site reactions, I don't even know that I am taking the drug.
I am with you both...whenever you need me....
BIG HUGSSS to you both,
Heather
Except for some injection site reactions, I don't even know that I am taking the drug.
I am with you both...whenever you need me....
BIG HUGSSS to you both,
Heather
Hi. I finally have my Copaxone in the fridge too. I've been bombarded with tote bags, an autoinjector, booklets, looseleaf binders, and on an on. On Thursday the nurse will come here and do her stuff. I'll post how it goes, and hope you will too.
ess
ess
Hi Heather:
Im so glad you could add that comment!!!! That will help aot of people! I just had a day today where i didnt have to deal with anything and have the day off.Iv had time to reflect on the ms dx of last week. So I thought I would post somthing for others for a change since Im always asking so many questions lol, I have the copaxone in the fridg and awaiting the welcome kit and nurse for first injection sometime this week wish me luck, I hope it help!!! All My Best Gollie
Im so glad you could add that comment!!!! That will help aot of people! I just had a day today where i didnt have to deal with anything and have the day off.Iv had time to reflect on the ms dx of last week. So I thought I would post somthing for others for a change since Im always asking so many questions lol, I have the copaxone in the fridg and awaiting the welcome kit and nurse for first injection sometime this week wish me luck, I hope it help!!! All My Best Gollie
I forgot to mention...any other drugs you may need, if your insurance doesn't cover them or the co-pays are too high for you to afford, there are also the drug manufacturers that will give you the medications you need at very little cost or no charge at all.
My daughter's husband lost his Medicaid coverage when he was approved for disability and she had to go to each one of the companies that made his drugs and fill out a form for assistance. He takes ALOT of drugs, due to his Lupus. All but one was covered for free or little to no cost. The other one, my daughter is able to get at a greatly reduced rate. This required a little homework on her part, but she was able to get the help she needed so her husband would not be without and they would not be poor, trying to buy all of his medications.
Best Wishes,
Heather
My daughter's husband lost his Medicaid coverage when he was approved for disability and she had to go to each one of the companies that made his drugs and fill out a form for assistance. He takes ALOT of drugs, due to his Lupus. All but one was covered for free or little to no cost. The other one, my daughter is able to get at a greatly reduced rate. This required a little homework on her part, but she was able to get the help she needed so her husband would not be without and they would not be poor, trying to buy all of his medications.
Best Wishes,
Heather
All of the drug manufacturers of ANY of the DMD's will give you the medication free of charge is you do not have insurance or your insurance will not cover it.
You never have to worry in the United States or even Canada that you can't get your injectable medications for MS.
Heather
You never have to worry in the United States or even Canada that you can't get your injectable medications for MS.
Heather
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