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Medicare Nightmare!

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    Medicare Nightmare!

    Hi all

    It is Medicare Open enrollment time again.
    What a stressful horrible nightmare!

    I thought I had it all figured out. Go with original Medicare, a drug plan and a supplemental plan.

    Original Medicare allows me to go to any doctor I want. The supplemental plan covers the 20 percent charges not covered by part b. And in theory the drug coverage is supposed to cover most of my drug costs.

    What a joke!

    My projected out of pocket costs for Copaxone are $48,000 for the year and $30,962 if I opt for the generic version!

    Last year I got a grant for $6000 that covered most of my out of pocket costs. I don't think that will work this year!

    I'm not sure why the costs are so high this year! Any ideas???


    I can't believe those figures are correct. I've been on Medicare (68) for three years, and unless you are referring to SSDI, and those rules are different, I believe you should look around. From what I found on "the Google", the catastrophic coverage begins at $5100 out-of-pocket costs, and from then on you only pay 5% of the cost.

    I will tell you that infusions are the way to go since they are covered under Part B because they are done in a hospital, and my total yearly cost is @$3600 for everything.

    I found a website that really helps, and you might want to visit it and take a look. It's like a brokerage for all the plans. It is called, and once you enter your zip code, it will take you to all the plans in your area: Supplementals, Advantage, and Part D. Once you enter the drugs you are taking, they will show you exactly what your costs will be. You can compare three plans at a time. Make sure you scroll down to the bottom of the page and click on "show all the plans". As an example, I entered Copaxone, chose three plans, and came up with a cost range of $558-589 a month including the premium. You can purchase the insurance with this website or call the company directly. I had great success using this site and have ordered insurance from them. is a MESS, and I never recommend it for anyone to use.

    Good luck!


      Thank you rucats I will take a look. It was on that i checked out all of the plans in my area code. They were all ridiculously expensive!


        I feel really stupid. I had put 12 in the quantity box because there were twelve shots. But that meant 12 boxes of 12 shots. No wonder it was so much more than last year!!
        Thank you RUcats I realized my mistake when I was entering my drugs. That brought my drug costs down to $5600 for the year! Still more than I want to pay.


          Call Medicare

          I did that when Humana kept taking away more of my meds. They all but admitted Humana is the worst at covering the good meds. Anyway, they found a supplement that would pay for all the meds I took except one. But even got that worked out.
          Long story short, calling Medicare was the best move I could have made. Saved me money and time of doing my own research.


            Thank you smiles.

            I did check out all the Medicare plans available in my area and mine was one of the cheapest and best rated.

            The good news is I just secured a grant from the Pan foundation that will cover my copays!

            I just wish the drug companies wouldn't make the drugs so expensive in the first place. It's bad enough having to deal with the other challenges of ms without having to worry drug costs!


              Thank you for sharing your experience with us


                Sorry, I don't have any suggestion but this line shocked me:

                Originally posted by Leenyi
                My projected out of pocket costs for Copaxone are $48,000 for the year and $30,962 if I opt for the generic version!
                And that's for Copaxone which has hard science/statistics that it does absolutely nothing in about 1/3 of the people injecting themselves with that DMT.

                It is a crime that both of our bought-and-paid-for ruling political parties refuse to implement a national health care system like every other advanced country on earth has! Such national health care systems are proven to be far cheaper and to give better health care results than the most-expensive-health-care-in-the-world that we fools in the USA put up with.
                59M / RRMS / Dx1987 / Ocrevus