Gilenya Insurance Coverage Outside of the US

[Linus01]

Greetings,

My wife has been offered a job outside the US and we are excited to accept the offer. However, her new insurance plan will not cover my Gilenya. So, I am looking at my options to figure out what insurance providers would cover Gilenya. Has anyone out there moved outside of the US and had luck finding an insurance company or policy that will cover the medication? I know this is a bit unusual, but the thought of turning down this opportunity because of this complication is like rubbing salt in the MS wound.

Thanks in advance!

[KitOP]

I'm not sure that there would be a carrier that would do this.

What I would suggest is for you to call Novartis and see what accommodations can be made for you. They may have plans in the country that you will be moving to.

Can't hurt to call and ask.

Good Luck to both you and your wife with her new job.

[onlyairfare]

This is a very complicated question because it depends on many different factors.

One is "What country are you moving to?" Might you be eligible for insurance offered within that country, besides the insurance offered by your wife's company?

Depending on how long you live there, you might become eligible for permanent residence or citizenship, and thus eligible for their national insurance.

Does the employer have more than one plan available? If she explained your insurance needs, might there be an alternative plan offered?

Gilenya is very expensive in the US, but may be available at lower cost in the country you are moving to, even if you pay cash. If the employer wants your wife to take the job offer, they might "make you whole" by reimbursing the cash cost of Gilenya outside of the insurance plan.

Will you maintain a US address and/or residence - your own home, or that of a friend or relative? Maybe you could choose to maintain US-based insurance just for obtaining Gilenya, then have it forwarded to you.

One place to find some answers might be the US Embassy in the country you will be moving to. You might also find a community of American ex-pats in your new country and ask them how they manage medical and insurance.

Perhaps your wife could talk with HR at her employer and ask for their suggestions on how to manage this. Large employers may have alternative arrangements for employees and their family members with special medical needs.

Sorry I have no solid answers, but those are a few ideas of how to approach your question.

[Linus01]

Great thoughts

The job is in Saudi Arabia. I have looked up the drug in Saudi and I know it is approved and looks like it runs about 32K per year. This is a bit cheaper than the US, but still a lot more than I'm willing (or able) to pay out of pocket. I think trying to obtain the drug with a US plan and having it shipped over there is likely my best option. I don't know if there are going to be residency restrictions though. I'm not sure if the new Affordable Healthcare Act will cover expat insurance or not. I have not had a chance to read all the message boards, but this may have been covered already. Thanks again for your thoughts.