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    Copaxone-Health Insurance Coverage

    My nuerologist has prescribed Copaxone for my MS. Unfortunately, it will cost about $1700 a month for this medication under Harvard Community Health Plan HMO in Massachusetts. Thanks Sparky for all the phone numbers to ask for assistance with paying for this medication.

    However, I am interested to hear from someone in Massachusetts that has more than 60% of the cost of the medication covered under their health insurance plan. Are there any health insurance plans that cover the cost of this prescription? Thanks for the input!

    #2
    Lauren, did you see the post on Shared Solutions Assistance? They have financial assistance available, and they are the providor of Copaxone.
    Dx: 2/3/12. 6-8 lesions right medulla/cervical spine. GLATIRAMER ACETATE 40 mg 1/19, medical marijuana 1/18. Modafinil 7/18, Women's multivitamin, Caltrate + D3, Iron, Vitamin C, Super B Complex, Probiotics, Magnesium, Biotin.

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      #3
      Thanks so much for the response. I did contact Shared Solutions but they are unable to help people that live in Massachusetts. Fortunately, Blue Cross Blue Shield does cover the cost of Copaxone with a small copay. I'm going to switch to this health plan is the after cost is lower.

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        #4
        BCBS

        What Blue Cross plan covers that much in co-pay? Mine is a 50% copay, and I simply cannot afford Copaxone, and they do not cover Tysabri at all. So I am stuck with no treatment, only symptom control medications.

        Lisa
        Lisa

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          #5
          It certainly is confusing

          what plan covers what. I have BCBS and they have a 50% copay for drugs (that's over $2200 per month for copaxone). How DO people get assistance from Shared Solutions that is enough to help.....

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            #6
            Originally posted by Lisasberry View Post
            What Blue Cross plan covers that much in co-pay? Mine is a 50% copay, and I simply cannot afford Copaxone, and they do not cover Tysabri at all. So I am stuck with no treatment, only symptom control medications.

            Lisa
            Lisa,

            if you want meds, contact each of the companies and explain your situation. Biogen, the maker of Tysabri has an excellent free medicine program. Shared solutions has a copay program, but no free medicine program. They can, however refer you to a charity called rx assist. Either way, you should not have to go without meds if you want them.

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              #7
              I tried RX Assist

              and was unable to get assistance because I have health insurance.. (premium is $900 per month)

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                #8
                Originally posted by its2much View Post
                and was unable to get assistance because I have health insurance.. (premium is $900 per month)
                Are you stuck on copaxone? It's true they don't give free meds like the other companies. So contact each of the companies and explain your situation entirely - even at 50% it's not unreasonable that you can't afford it.

                One of them will send you free Medicine. Contact me personally and I will tell you my story. You can email me from my profile. But I believe you can get meds if you want them.

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                  #9
                  50% of the monthly cost

                  50% of the monthly cost of copaxone equals over $2200 per month....

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                    #10
                    Lisasberry, there is a program in OK called MS Bridge. Please call the MS office in OKC for their contact information.

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                      #11
                      When I was on Avonex it was $25.00/month under Fallon Direct Commonwealth of Massachusetts plan.

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                        #12
                        BigA

                        Please check your email. I contacted shared solutions again.

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                          #13
                          I'm not sure if Rebif is an option for you or not. My neuro said it is basically a bigger version of copaxone. (not sure if my simplified understanding of it is gospel or not) Ms lifelines is a company that my neuro contacted for me.

                          They guaranteed me my first 3mo of rebif free and $50 after that for as long as i took it. I'm still not sure exactly how that works but I do know they did alot of dancing with my health insurance (united).

                          I do know that my first box of rebif arrived with lower dose to titrate up on it and see what i can handle. maybe it is possible to just take a lower dose of it?

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                            #14
                            Rebif

                            has some nasty side effects, especially at the beginning. It certainly is not for everyone. Due to other health issues, some cannot use it.

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                              #15
                              Originally posted by kriscake View Post
                              I'm not sure if Rebif is an option for you or not. My neuro said it is basically a bigger version of copaxone. (not sure if my simplified understanding of it is gospel or not) Ms lifelines is a company that my neuro contacted for me.

                              They guaranteed me my first 3mo of rebif free and $50 after that for as long as i took it. I'm still not sure exactly how that works but I do know they did alot of dancing with my health insurance (united).

                              I do know that my first box of rebif arrived with lower dose to titrate up on it and see what i can handle. maybe it is possible to just take a lower dose of it?
                              I think you're mixing up copaxone and rebif. Rebif is a bigger version of Avonex. It's more of the same drug. Copaxone is completly different from any of the other drugs. Nothing is like it. The amazing thing is that copaxone was invented to produce EAE, the so-called animal model of MS. They gave it to the animals and they seemed to get better.

                              So if you fail on avonex, or have an adverse reaction, Rebif is generally not a good alternative, since it's more of the same.

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