Cost of Ocrevus while on Medicare

[Lianne]

I'm thinking of starting Ocrevus and I can't find anything on how much it will cost for someone on Medicare, other than a range of from 0 to $13,000. I'm on a tight budget and not sure if I can afford it. If anyone can tell me how much they pay for this I'd really appreciate it.

[REG53]

Hello Liann, Ocrevus is covered under my medicare part B medical. I pay .00

Wishing you all the best in what ever you choose.

[Lianne]

Thanks, Reg53, that's good to hear.

[pb909]

Mine falls under Part D and it is expensive for me.

Not sure why the difference?

[kmallory1]

Ocrevus is a treatment administered in an infusion center so it’s covered under my Medicare part B. That pays 80% of the amount. The remaining 20% is covered by my Medigap policy.

It is a high deductible plan, so I pay about $2,300 out of pocket for the year.

[Lianne]

Based on what I'm reading it doesn't make sense for Ocrevus to be covered under part D. Is anyone else paying for this through part D?

[Kimba22]

Based on what I'm reading it doesn't make sense for Ocrevus to be covered under part D.

I am still covered by commercial insurance thru my husband's employer, but I seem to be reading the same thing as you ~

It is important to note that medications given intravenously or by infusion, including Tysabri®, Novantrone, and any type of IV steroid, are not billed under Medicare Part D. These are billed through Medicare Part B because they require the services of a physician.

https://www.nationalmssociety.org/Li...omparing-Plans


Does Medicare Cover Ocrevus?

Ocrevus is not currently covered by Medicare Part D prescription drug coverage. Ocrevus is administered as an injection that infuses the body’s blood with the drug. As a result, Ocrevus is not available through retail pharmacy locations and can’t be self-administered. Furthermore, testing may need to be completed prior to starting Ocrevus, and patients taking this medication will often need to undergo extended monitoring to ensure the proper dosage and frequency of administration.

Although Part D does not cover Ocrevus, some Medicare recipients may be able to receive coverage for the drug when it is deemed medically necessary and is administered by a physician or skilled nursing professional. This may happen in a certified skilled nursing facility or in an outpatient clinical setting, allowing for potential coverage under Medicare Parts A and B respectively. Coverage may also be granted incident-to a hospital stay after an emergency. Medicare Advantage plan members will have at least the same Part A and Part B benefits as Original Medicare, but many offer additional coverage.

https://www.medicare.org/articles/do...cover-ocrevus/