Just wondering

[Barbie51]

Has anyone else read in their papers that insurance companies are wanting to change the way they charge?  They no longer want to pay for expensive drugs, e.g. MS drugs.  They would like to charge 25 to 33% rather than the $30 for 3 month supply many are able to pay now.  I, for one, will have to think long and hard about continuing my drug therapy if this comes to pass.  Insurance philosophy has historically been that everyone paying the same protects those that are seriously or chronically ill, but now they're wanting the seriously ill to pay much more.  I don't know how close we are to this coming to pass.

barbie 51

[MCBCON]

Speaking to the US Government mind you:

You are a bunch of robbing A.S.S.H.O.L.E.S

[Cosmobirdy]

Good Night Nurse!!!  To charge people that kind of money, when they are ALREADY on disability, is a sin in my book.  I mean, it's not like you're rolling in money as it is, right?  But I bet if you were a CEO of some big company, making millions each year and could actually AFFORD this kind of monthly cost, your coverage would be complete.  This kind of thing really honks me off....

Being medical, we both know darn well that these drug companies are not hard up for money, nor are the insurance companies.  Yet it seems like they want to penalize most the very people who need the coverage because they have a long term health issue.  What is wrong with this picture??

Rita        

[Quixotic1]

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!  Defining the "lower" end of the hole by total cost of the meds to you and Medicare and then by defining the "upper" end of the donut hole just by what YOU have paid out of pocket.

So, I paid $1715 last month and again this month.  Then I get to drop down to $172 per month for the rest of the year.

Yes, in this time of recession, the Robber Barons continue to get richer.  Oil, Insurance, Pharmaceuticals, Bankers.  In general, it's not a good time to be sick or poor.  Where's my silver spoon?

Q

[Barbie51]

My daughter actually told me the same thing, MCGCON, and I thought it sounded reasonable.  I appreciate all the shared ideas and I realize there are some proactive things I can do.
Thanks,
Barb

[MCBCON]

I think if insurance companies do this then there will be alot of folks not taking meds.

When this occurs the drug companies will loose a lot of sales.  The actual low cost of these drugs to the drug companies might very well dictate that it be passed on to the consumer so that sales might return.

I realize this is a pipe dream.  But, hey I am allowed once in a while.

[doublevision1]

That IS distressing.  Is this something your local or national MS Societies are aware of and addressing?  They should be playing a strong role in advocating for reasonable access to MS meds.  Another idea: try to find out more about what the insurance companies have in the works and then write to your government representatives to alert them.  I'm not sure what role govt plays in these issues in the US, but it is maybe worth a shot.  

In Alberta, Canada there is a provincial MS drug program.  The co-pay is $25 per month (waived if one is low income).  One must first apply for non-group insurance, even if you already have other insurance.  There are no disqualifiers for the non-group insurance, and it has low premiums.  For the MS drug program, a panel of neurologists review applications and basically if you have a definitive dx of MS by an MS specialist, and, have the non-group insurance, you qualify for the program.  It is not needs based.  

I was informed today that my application has been approved.  I am very fortunate in that I also have drug coverage through work, and with both plans linked, I now have no co-pay for my meds.

However I take NOTHING for granted and will be keeping an eye on my government's commitment to this program.  

db1

[Cosmobirdy]

OMG...I saw that yesterday and almost had a stroke!  I called the benefits coodinator for my hubby's job, and talked to her right away.  She said things for us were stable till the contract is re-negotiated in Oct. of 2009.  

I currently pay $40 a month for my Rebif.  If it changes to those higher prices, and it went to $325 per month like it did for the woman in the article, there's just no way we could afford that.....It is so frustrating to have to worry about these kinds of issues, when we all have enough to deal with as it is...

Until this all came up for me, I never really even thought about these things.  Now I seem to be hemorrhaging money, between doctor visits, deductibles, copays for various tests, and then monthly medications.  And now I am paying attention to each EOB to see how much has been applied to my lifetime cap.....  

I am hoping that now that I am diagnosed, and I've had what seems like every test possible, that it will start to slow down.  But it's always a concern at the back of my mind now.  I told my hubby I feel like the family money pit these days... :)  

Rita