copaxone tier formulary

[oxshananxo]

Can anyone explain the way Medicare works with part d coverage for copaxone? The term catastrophic coverage has raised my eyebrow a smidge.  I'm awaiting a call back from shared solutions and their "medicare" expert team. If im understanding the sales lady right, she informed me I would be responsible for the first $4700 approx.?  I get very frustrated with being on hold and waiting for callbacks and being told I need to call a different agencies when Im in a relapse as it is and im trying to get answers now! I can only afford max 100 a month for my therapy. (Apposed to the outrageous price tag of $35000 us dollars annually) I know there must be others that have faced this same dilemma. Share your solutions with me..please.

[oxshananxo]

Sarah, thanks for answering! I do have some good news to share with you. Shared Solutions does indeed accept Medicare. The hoops they jump through vary a little from standard insurances from my understanding. Basically they send an 'are you sure' letter to the neuro ofc asking if any other treatment is available to you. The lady I spoke with yesterday indicated its a different department and obtaining the initial treatment is a little different but once they set up your account your good to go. The problem im having is that darn 33% on tier 5 meds. Copaxone is just spendy. Anyway you divide it. They assured me supplemental programs were available, its just finding the right one that pays. And if that fails, they have a categorically needy program through state departments such as dshs here in Washington that fund it upon qualifying. I adamantly just said that I want this therapy, I need this therapy, I get Medicare because I have m.s. Shouldn't I qualify for this medicine? She agreed. Ill let you know if it works!

[SarahL2491]

I was told that shared solutions would not work with medicare at all; that they would not pay for anything for people on medicare.  
contact the MS society, they have lots of solutions.
if you have part D, ask your insurance co that supplies part D how they pay for copaxone.  

I'm dreading it because I start on it this winter also and am on medicare