I'm sorry I did not post this at the end of last year or earlier this month to maximize everyone's savings. This is something to keep in mind for 2015.
US healthcare is often a major expense, especially with a chronic health condition like Multiple Sclerosis(MS). Our MS medications easily run from the $30-60K range on an annual basis, basically forcing companies to have financial assistance programs. By allowing your “co-pay assistance” program to help pay your deductible you can save $100s if not $1000s of dollars.
For those with an insurance plan with a deductible this post may outline a potential method to reduce your monthly out of pocket expenses and hopefully help meet your annual deductible. Each year, your insurance company expects you to pay your deductible before resuming making most types of payments on your behalf.
How this works:
Co-Pay Assistance Programs for MS Medications
MS Active Source (Avonex, Tysabri, Tecfidera): 800-456-2255
MS Pathways (Betaseron): 800-788-1467
Exavia Go Program(Extavia): 866-398-2842
MS Life Lines (Rebif): 877-447-3243
Shared Solutions (Copaxone): 800-887-8100
Novartis Patient Services (Gilenya): 877-408-4974
Aubagio Patient Services (Aubagio): 855-676-6326
I wish you all well ...
US healthcare is often a major expense, especially with a chronic health condition like Multiple Sclerosis(MS). Our MS medications easily run from the $30-60K range on an annual basis, basically forcing companies to have financial assistance programs. By allowing your “co-pay assistance” program to help pay your deductible you can save $100s if not $1000s of dollars.
For those with an insurance plan with a deductible this post may outline a potential method to reduce your monthly out of pocket expenses and hopefully help meet your annual deductible. Each year, your insurance company expects you to pay your deductible before resuming making most types of payments on your behalf.
For example, if your deductible is $1,000 you will need to pay the first $1,000 of medical expenses before your insurance company will begin to pay for doctor’s appointments or medications. Your family may have even a larger deductible potentially saving you even more money.
The good news is most co-pay assistance payments will count towards your deductible. Considering our medications run upwards of $2500/month it is possible that your co-pay insurance plan can cover your entire deductible. If you have a pending large expense (i.e. wheelchair purchase, screening MRI, colonoscopy or other non-emergency surgery, etc.) you may delay them until after your deductible is paid by co-pay assistance and save the out-of-pocket expense.How this works:
- Review your insurance plan and determine what your annual deductibles are. If necessary, you can contact the toll-free number on the back of your insurance card for assistance. The information should also be available online by logging into your insurance company’s website.
- Contact the manufacturer (listed at the bottom) of your MS medication and inquire about their co-pay assistance plan. If you signed up last year, you will probably only need to renew this year. Ensure you write down the necessary information to give to the pharmacy and keep a copy for your records Many programs are limited for those with government-backed healthcare (Medicare/Medicaid/etc).My example: I renewed my co-pay assistance plan qualifying for up for $15,000 annually in co-pay assistance. This covers my ENTIRE deductible leaving me with only the minimum $10/month payment. That’s really good for a 15-minute phone call, but set aside a good hour due to hold times.
- After you have the co-pay information (i.e. BIN#/PCN/GROUP#/ID#/etc), call your specialty pharmacy to schedule your next medication shipment. Inform them you have co-pay assistance from the drug manufacturer that you want them to apply to your payment. They should process the order and tell you; how much the drug cost, how much the co-pay assistance paid and how much co-pay assistance covered. My co-pay assistance plan paid right at $1700 this month.
- Wait 24 hours and contact your insurance carrier and ask them what, if any, of the co-pay assistance payment was applied to your deductible. In some cases, your deductible will be 100% paid, saving you 100s if not 1000s of dollars. If you have a very high deductible it may take a few months for the co-pay assistance plan to zero-out your out-of-pocket expenses.
- If you saved money using this method, please consider making a donation to MSWorld or to further MS research.
Co-Pay Assistance Programs for MS Medications
MS Active Source (Avonex, Tysabri, Tecfidera): 800-456-2255
MS Pathways (Betaseron): 800-788-1467
Exavia Go Program(Extavia): 866-398-2842
MS Life Lines (Rebif): 877-447-3243
Shared Solutions (Copaxone): 800-887-8100
Novartis Patient Services (Gilenya): 877-408-4974
Aubagio Patient Services (Aubagio): 855-676-6326
I wish you all well ...
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