I just called my insurance company. I was getting several different amounts from the Avonex rep, so I decided to call on my own. Today I was told by the Avonex rep I would have to pay $300.00 a month. So I decided to get on the phone and call myself!
I get a 30 day supply for $150.00 or a 90 day for $300.00 The $90.00 day supply would make it $100.00 a month. I would much rather pay that amount out of pocket than touch our retirement!
I hope there might be some sort of assistance without draining future. The Avonex rep is checking into funding for me. So, we'll see.
LA
[QUOTE=MSNik;3480427]Im not clear on what type of health insurance you have. but MANY of them have much lower deductibles then 300$ !! Thats rediculous. As for the retirement fund, I had to use all of ours up a few months ago...we basically are starting over and my husband and I are both in our 40s....he has a lung disease and I have MS...not a pretty picture. I feel for you.
Look into finding a way to lower that deductible..call your insurance company, call Shared Solutions, call everyone! It cant hurt.
I called Avonex and got my answer. You CAN have a 401K, IRA, savings, other resources. They just look at the WHOLE financial situation. We are a family of 7 and they said we do qualify based on our income.
So, I can rest easier! I feel like I have been left trying to connect the dots and I am pretty frustrated. :(
I thought I would get help all the way through the process of setting up the Avonex treatment. They are "helping" but we don't seem to be getting anywhere. But then I have not had my diagnosis a month yet...maybe I am expecting too much.
well, thats good. Not great, but better. I dont know why you ever would have thought it was 300$ a month, thats a very high amount. There is one thing you should also check into....in the USA, most injectables, are sent thru the mail- and most companies will not send you 90 days at a time...in fact, some pharmacies will NOT ship more than 30 day supply at once. I know mine, wont. I can only get one box of syringes...keep in mind, Avonex is only once a week...mine is three times a week...copaxone is daily....so I dont know for sure what insurance you have or what pharmacy they use- but FIRST make sure they are SHIPPING this to you, the cost to have it shipped is about 1/5 of what it costs to pick it up at a pharmacy...and second, verify that they will send you 3 months at once.
good luck to you.
N
hi again. Just read your newest post, which you were typing, when I was responding to the other one. Again, without knowing your insurance, or your benefits, I cant say what to expect...but defintaely look into the two things I said..where it is coming from, being sure that it is by mail- and also finding out if they will ship you 3 months at a time. I KNOW Avonex, straight from the manufacturer didnt used to ship more than one month at a time, but I do not know if that has changed...I also think that their "help" is only for one year..after that, you are on your own....thats how it used to be. Again, it might have changed...all drug companies offer help for those who qualify, and if you have that large a family and little income, you should qualify.
also, isnt your doctor setting this all up for you? Your Neuro should be faxing in a script to your insurance company and they should be talking to you about the choices you have in getting the drug...follow up on that before you do anything.....
I checked with my insurance company and I can get my Avonex from the pharmacy or through mail order for either a 30 day or 90 day supply. The co-pay is the same in each case.
The $300.00 a month is the amount the lady at Avonex gave me. That is why I decided to call my insurance company myself. I think there is a break down in communication for some reason. Other than that I have no idea what is going on. Our out of pocket for scripts per month is $150.00. Which is pretty good considering what it could be!
I called Avonex back to let them know what our insurance rep told me. I also wrote everything down including names and dates. So now I feel like I have the dots connected! :D
LA
[QUOTE=MSNik;3480539]well, thats good. Not great, but better. I dont know why you ever would have thought it was 300$ a month, thats a very high amount. There is one thing you should also check into....in the USA, most injectables, are sent thru the mail- and most companies will not send you 90 days at a time...in fact, some pharmacies will NOT ship more than 30 day supply at once. I know mine, wont. I can only get one box of syringes...keep in mind, Avonex is only once a week...mine is three times a week...copaxone is daily....so I dont know for sure what insurance you have or what pharmacy they use- but FIRST make sure they are SHIPPING this to you, the cost to have it shipped is about 1/5 of what it costs to pick it up at a pharmacy...and second, verify that they will send you 3 months at once.
good luck to you.
N
My doctor did get things started and we were sailing along until the insurance issue came up. I am not too sure my Avonex rep is following up. She was supposed to see if I need a PA for my Avonex. That was last week and I never heard back from her.
From what I can find in my insurance information I do NOT need a PA. But I am going to call the insurance company tomorrow to make sure.
On the bright side of this Avonex is going to continue sending me my medication free of charge until this all gets worked out!
LA
[QUOTE=MSNik;3480542]hi again. Just read your newest post, which you were typing, when I was responding to the other one. Again, without knowing your insurance, or your benefits, I cant say what to expect...but defintaely look into the two things I said..where it is coming from, being sure that it is by mail- and also finding out if they will ship you 3 months at a time. I KNOW Avonex, straight from the manufacturer didnt used to ship more than one month at a time, but I do not know if that has changed...I also think that their "help" is only for one year..after that, you are on your own....thats how it used to be. Again, it might have changed...all drug companies offer help for those who qualify, and if you have that large a family and little income, you should qualify.
also, isnt your doctor setting this all up for you? Your Neuro should be faxing in a script to your insurance company and they should be talking to you about the choices you have in getting the drug...follow up on that before you do anything.....
I'm glad that Avonex is sending you meds until it's worked out. I just went through a similar situation (I'm on Avonex too) and the culprit turned out to be a computer glitch between my insurance company and the Avonex pharmacy. It's a big pain and it's a shame that people have to go through all of these hassles. It sounds like you're doing a great job documenting things. There's a big difference between $150.00 and $300.00!!
April,
Thanks for posting this. I hate to be too quick to blame my Avonex rep for dropping the ball but that is what seems to be happening to me right now.
Maybe a computer glitch does explain it. There was a problem with communication between the Avonex support and the pharmacy.
The pharmacy that is supposed to mail order my Avonex quoted me $900.00 for a 3 month supply!! YIKES!! The Avonex rep quoted me 150.00 for 30 days or 300.00 for 90 days. That was 2 weeks ago.
Today I was again given the 900.00 amount for a 90 day supply by an Avonex rep. So, something is just not right.
I called my insurance company directly to get this worked out. The Avonex funding rep is going to call me tomorrow. MAYBE someone will finally get all of this connected for me. UGH.... this is not what I wanted to be dealing with right now. But you are right, it is good they are still going to send me the Avonex while we get this figured out.
LA
[QUOTE=april1848;3480590]I'm glad that Avonex is sending you meds until it's worked out. I just went through a similar situation (I'm on Avonex too) and the culprit turned out to be a computer glitch between my insurance company and the Avonex pharmacy. It's a big pain and it's a shame that people have to go through all of these hassles. It sounds like you're doing a great job documenting things. There's a big difference between $150.00 and $300.00!!
