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Co-pay assistance for Gilenya on Medicare?

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    Co-pay assistance for Gilenya on Medicare?

    I have been on Gilenya for many years and have never had to pay anything for my meds while on my husband's insurance (Gilenya pays my co-pay). Starting the first of the year I am being forced to go on Medicare (because I'm on disability) with my husband's insurance will be the secondary payer. I will be on Medicare part A and B and his insurance will cover medications.

    I spoke to the Gilenya go program and because I will be on Medicare they claim they will no longer cover the co-pay. Has anyone found a way around this? I have to pay for premiums for Medicare and my husband's insurance, and now at least $100 for Gilenya every month. Feeling really overwhelmed! I am grateful to have insurance but all these healthcare expenses are a real financial burden!

    Sorry to complain and thanks in advance!

    #2
    My understanding has been that the drug companies can not offer the copay assistance to anyone on Medicare because it is a government program. However, if you go to Medicare.gov and type ďpharmaceutical assistanceĒ in the search box it will take you to a page that has copay assistance programs. There are two that show up for Gilenya.
    Since these are listed on Medicareís web site I would hope they are for people on Medicare.


    Also, the Center for Medicare Advocacy (medicareadvocacy.org) has a prescription assistance section.

    I have not tried to use any of these programs, since Iím on Ocrevus. It might be worth trying.

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      #3
      Thank you so much for responding! I tried searching for "pharmaceutical assistance" on the medicare website and could not find the page you were referencing. I will keep looking and making phone calls now that my head is a little clearer. I appreciate your help and hope you are doing well on Ocrevus!

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        #4
        This is the link, if the admins allow it...

        Https://www.medicare.gov/pharmaceuti...tance-program/

        Youíre right, putting pharmaceutical assistance in the search box didnít work when I tried it. I find things poking around then canít find them again, or remember how I got there.

        Good luck with your search.

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          #5
          copay assistance while on medicare

          I have been taking Tecfidera for 4 years. This past year I have been on Medicare. Biogen helped find an assistance fund for me with a small copay required by me and the rest of it payed by the assistance fund. Gilenya should be able to help you with this. This is the time of year to be looking into assistance from these funds.

          Hope this was helpful

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            #6
            Yes, this was very helpful. I'm glad you are able to get assistance for your medication. Thank you so much for responding!

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              #7
              Originally posted by kmallory1 View Post
              This is the link, if the admins allow it...

              Https://www.medicare.gov/pharmaceuti...tance-program/

              Youíre right, putting pharmaceutical assistance in the search box didnít work when I tried it. I find things poking around then canít find them again, or remember how I got there.

              Good luck with your search.
              Thank you so much for taking the time to add this link. I would have never found it on my own! Hopefully this information will help my case!

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