Guest guest Posted February 12, 2009 Report Share Posted February 12, 2009 Hi Dana, I just checked the Medicare drug formulary and it is still a covered drug. Go to the Medicare website and you’ll be able to see which plans cover it. But from Medicare D standpoint, it is still a covered drug. From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Dana T Sent: Thursday, February 12, 2009 10:02 AM To: TxFinancialCoordinators Subject: valcyte / Humana Good Morning All, I have a lot of patients who have Humana as their Part D and I was informed by Humana that Valcyte is now a non covered drug for the 2009 year. Are any of you running into that? Any info on what you are doing with your patients would be extremely appreciated!! Thanks in advance for any response!! Have a Great Day! Dana Trujillo TFC Sanford Transplant Center Sioux Falls, SD Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 12, 2009 Report Share Posted February 12, 2009 Yes if you look on the drug list it shows that if you have the standard humana plan that it is not covered however if they have the Humana HMO, or Humana advantage care it is covered, for the ones that have the Med D standard plan you can use the alternatives: Ganciclovir, cytovene these are covered under this plan Nimmo- , MA Financial Counselor With out goals and plans to reach them You are like a ship that has set sail with no destination.. From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Dana T Sent: Thursday, February 12, 2009 10:02 AM To: TxFinancialCoordinators Subject: valcyte / Humana Good Morning All, I have a lot of patients who have Humana as their Part D and I was informed by Humana that Valcyte is now a non covered drug for the 2009 year. Are any of you running into that? Any info on what you are doing with your patients would be extremely appreciated!! Thanks in advance for any response!! Have a Great Day! Dana Trujillo TFC Sanford Transplant Center Sioux Falls, SD Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 12, 2009 Report Share Posted February 12, 2009 Yes, we have a lot of patients on this plan as well. We apply for assistance thru the drug company and advising them to change plans. It is my understanding that the patient is allowed to make one change per year outside of the open enrollment if they are enrolled in Kidney Health. I am also finding several plans that are making Valcyte a Tier 4 that the patient is to pay 33% of the cost. This can be difficult as well. Good Luck. Amellia >>> Dana T 2/12/2009 9:02 AM >>> Good Morning All, I have a lot of patients who have Humana as their Part D and I was informed by Humana that Valcyte is now a non covered drug for the 2009 year. Are any of you running into that? Any info on what you are doing with your patients would be extremely appreciated!! Thanks in advance for any response!! Have a Great Day! Dana Trujillo TFC Sanford Transplant Center Sioux Falls, SD Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 12, 2009 Report Share Posted February 12, 2009 Yes Amelia you are right, I had a patient discharged yesterday her co pay for Valcyte was $400! From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Amellia Gay Sent: Thursday, February 12, 2009 10:34 AM To: TxFinancialCoordinators Subject: Re: valcyte / Humana Yes, we have a lot of patients on this plan as well. We apply for assistance thru the drug company and advising them to change plans. It is my understanding that the patient is allowed to make one change per year outside of the open enrollment if they are enrolled in Kidney Health. I am also finding several plans that are making Valcyte a Tier 4 that the patient is to pay 33% of the cost. This can be difficult as well. Good Luck. Amellia >>> Dana T <danartru> 2/12/2009 9:02 AM >>> Good Morning All, I have a lot of patients who have Humana as their Part D and I was informed by Humana that Valcyte is now a non covered drug for the 2009 year. Are any of you running into that? Any info on what you are doing with your patients would be extremely appreciated!! Thanks in advance for any response!! Have a Great Day! Dana Trujillo TFC Sanford Transplant Center Sioux Falls, SD Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 12, 2009 Report Share Posted February 12, 2009 Hi Dana, wasn't that a nasty surprise? We had 2 pts called in for transplant w/Humana PDP. Our requests for formulary exception were denied, appealed and denied again. One pt had LIS and we were able to switch him to a PDP w/Valcyte on the formulary, the other pt was over income for PAP so he was put on ganciclovir, which in fact is not a whole lot cheaper. Here's something I learned for future reference. There are a few PDPs out there w/coverage for generics in the donut hole, (Silverscript Complete is one) and they cover ganciclovir for as little as $6. Although these are higher premium plans, we'll be recommending them until those plans discover their "mistake." -----Original Message-----From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ]On Behalf Of Dana TSent: Thursday, February 12, 2009 7:02 AMTo: TxFinancialCoordinators Subject: valcyte / Humana Good Morning All, I have a lot of patients who have Humana as their Part D and I was informed by Humana that Valcyte is now a non covered drug for the 2009 year. Are any of you running into that? Any info on what you are doing with your patients would be extremely appreciated!! Thanks in advance for any response!! Have a Great Day! Dana Trujillo TFC Sanford Transplant Center Sioux Falls, SD Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 12, 2009 Report Share Posted February 12, 2009 Wonder if Roche knows about this? Daryl Battin, LICSW Financial Coordinator/Social Worker Lahey Clinic Kidney Transplant 41 Mall Road, Burlington, MA 01805 Ph: /FAX: Page: From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of on, :LPH Trnsplnt Sent: Thursday, February 12, 2009 11:49 AM To: TxFinancialCoordinators Subject: RE: valcyte / Humana Hi Dana, wasn't that a nasty surprise? We had 2 pts called in for transplant w/Humana PDP. Our requests for formulary exception were denied, appealed and denied again. One pt had LIS and we were able to switch him to a PDP w/Valcyte on the formulary, the other pt was over income for PAP so he was put on ganciclovir, which in fact is not a whole lot cheaper. Here's something I learned for future reference. There are a few PDPs out there w/coverage for generics in the donut hole, (Silverscript Complete is one) and they cover ganciclovir for as little as $6. Although these are higher premium plans, we'll be recommending them until those plans discover their " mistake. " valcyte / Humana Good Morning All, I have a lot of patients who have Humana as their Part D and I was informed by Humana that Valcyte is now a non covered drug for the 2009 year. Are any of you running into that? Any info on what you are doing with your patients would be extremely appreciated!! Thanks in advance for any response!! Have a Great Day! Dana Trujillo TFC Sanford Transplant Center Sioux Falls, SD See our web page at http://www.lahey.org for a full directory of Lahey sites, staff, services and career opportunities.THIS MESSAGE IS INTENDED FOR THE USE OF THE PERSON TO WHOM IT IS ADDRESSED. IT MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW. If you are not the intended recipient, your use of this message for any purpose is strictly prohibited. If you have received this communication in error, please delete the message and notify the sender so that we may correct our records. Quote Link to comment Share on other sites More sharing options...
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