Re: Anyone on Medicare and getting biologics paid for?

[Guest guest]

I have only had PsA for a year and a half but Medicare was not the problem in

getting it paid for.  It was my supplemental insurance that had to approve it.  

 Joanna Hoelscher

[Guest guest]

I'm on Medicare and my rheumatologist told me that the infusions are handled as

a treatment rather than as a drug. My supplemental insurance has mostly covered

Enbrel and now Humira. It took a while to get the approval, though. My

insurance is a continuation of what I had while I was working and is a large

group policy.

Shevlin

[Guest guest]

Are you on the medicare drug program? If so you can in most cases have the

doctor file to get non approved medications approved just like you can with

private insurance.

Celeste

[Guest guest]

Sharon

Medicare does cover Remicade and in the office now, in the beginning I

had to go to the infusion clinic at the hospital. (I felt like I was

invading the territory/privacy of the cancer patients.) Medicare pays

80%. The remaining 20% is your responsibility. If you do not have co-

insurance there are foundations that will help with the 20. Your

rheumy's office will more than likely have information on those

organizations. Remicade is wonderful in my opinion. Good Luck!

-Eileen

[Guest guest]

When Medicare first came out with the drug programs I was still on my husband's

insurance at work.  He retired in April and I got an AARP medical supplement and

an AARP drug supplement.  I am going to talk to my rheumy soon and see if she

can't get the wheels rolling to move me to one of the biologics.

 

Sharon Hanna <hanna1946@...>

[Guest guest]

Thanks Joanna. I wasn't thinking about this clearly! LOL. What I

meant was...is anyone on Remicade which is given by infusion and

Medicare covering it? My rheumy said that is one way to get it

covered better is to be on the Remicade and then have to have it

infused in a clinic setting with an RN at your side. I think she

said she had several patients on it and they get their infusions

there in the chemotherapy clinic in the office building (Diagnostic

Clinic) where her office is.

Sharon

[Guest guest]

I have an AARP drug supplement. I am not 65 yet so I had to get one of

the two policies offered in this area for people on disability. I have

a call in to my rheumy to ask about being switched to Remicade since it

is one of those that is infused in a clinic setting.

Sharon

[Guest guest]

Thank you Eileen!  I didn't get to talk to my rheumy today (she was out of the

office) but I will talk to her tomorrow...or her nurse about getting started on

it!  I do have an AARP supplement that I just got a couple months ago.  I hope

they don't give me problems approving it.

Sharon Hanna <hanna1946@...>