Insurance and Copaxone

[its2much]

Shared Solutions Assistance

BigA, kgrant2 and jmerced would you kindly email me (my address is on my profile). I have a couple of questions regarding Shared Solutions copay assistance program. I appreciate it!

[Anthea]

How could this be? Cop costs ca. 2000 $ here in Germany for 4 weeks and I only have to pay ca. 13 $ . The rest is paid by my insurance.

Why is Cop so expensive over there?

[MrsBones]

How could this be? Cop costs ca. 2000 $ here in Germany for 4 weeks and I only have to pay ca. 13 $ . The rest is paid by my insurance.

Why is Cop so expensive over there?

It isn't for everyone. With one insurance, I paid nothing, another I paid $35 and a third, I paid $50. Just depends on what an individual's insurance will cover and how.

[GracieBH]

Shared Solutions helped me with my copay, took about 2 weeks, but all is good.

However, $10,000? per month...that does not seem right, seems inflated for some reason. Throws some red flags about why double the amount and whose jacking the price up.

[its2much]

Your Copay Grace

Would you please email me (my email is on my profile). I have a question about your copay and Shared Solutions. Thanks!

[Anthea]

It isn't for everyone. With one insurance, I paid nothing, another I paid $35 and a third, I paid $50. Just depends on what an individual's insurance will cover and how.

Thx for the explanation. Here in Germany everyone has to pay the same amount (10 Euro) no matter what insurance company he/she has.

[jmerced]

jmerced is shared solutions now paying your total copay - out of pocket?

Sorry, its2much, I'm a selfish poster! Turns out my pharmacy was just wrong, and my financial assistance through Shared Solutions still covers everything with my insurance company.

I read through some of your threads after noticing your interest in my assistance. You have a government issued kind of insurance and Shared Solutions denied assistance? That sucks. They're usually pretty empathetic, did they offer you any alternatives? I'd hit up your National MS Society chapter.

[its2much]

Thanks jmerced

I do not have government insurance - I've purchased a private policy (had private insurance which I paid for myself prior to that - premiums got much too high so I had to stop it in 2010. In 2011 I was able to get insurance, even with my pre-existing MS, thanks to the Obama Health Care Act at a lower price than before but it's still expensive) I applied through Shared Solutions and was denied because I have insurance. Prescription drugs are subject to a 50% co-pay which makes the monthly out of pocket over $2150.

Shared solutions said they would give me $500 monthly towards the cost of Copaxone - actually I don't think I get it directly - I think the pharmacy gets it - I never really got that far as I can't afford $1650 per month.
So when I see that people who do have health insurance are able to get assistance I get confused.

Do you still have a deductible to meet, or is that taken care of since Shared Solutions is working with your insurance company? How about maximum out of pocket? I take several other drugs. I also have other health issues which require monitoring with various tests.

[its2much]

oops one more question

Please read my post above. What was Copaxone going to cost your BEFORE Shared Solutions got you assistance?

[jmerced]

I feel like it must be the difference in insurance companies and policies. My out of pocket max for pharmaceuticals is $3500 annually, so maybe it was just really easy for Shared Solutions to assist with that amount? Maybe because it's Obama care, the negotiated rate of the medication is much less, making the profit for the drug company less?

I wish I knew more about this stuff, but I don't. I really think you should contact the MS Society, they're here to help.

[its2much]

My insurance is

with Blue Cross Blue Shield. But your maximum out of pocket for prescriptions maybe is the reason. I've spoken to the National MS Society, and the MSAA. No one can believe I have a 50% copay for prescriptions. Are you taking any other prescriptions besides copaxone? How are those paid for? I know you probably mentioned it but how much is your cost now for copaxone?

[jmerced]

It's nothing. I have a prescription for Nuvigil that I rarely get filled because I hardly take it, can't remember what I pay. I have a prescription for Welbutrin that's $10...

Maybe it's worth looking into another one of the CRAB medications, maybe they'll supply finical support. So crazy that in almost every other country, health care and medications are provided free of cost for people diagnosed with an incurable disease.

Best of luck.