Surprise Bill

[dyin_myelin]

I just spent two years in the hospital for trying to kill myself. They handled everything and if I wanted to be released I had to be treatment compliant. I was getting the infusions twice a year. I lost everything except my net worth and my private healthcare and I was clinging onto that in a hopeless time. Now I have a bill for 70K from the infusion center and a check for 30k from Blue Cross that my power of attorney was so excited by like it was free money. Could the drug company help me retroactively? I now have such bad cognitive issues I struggle to do basic tasks. I'm homeless and everything is in storage. What should I do? I don't have my new neuros name.

[pennstater]

dyin_myelin - I am so sorry to hear. After such a rough ordeal, the last thing you need are hidden surprises.

When facing cognitively difficult challenges, I keep a notebook (number each page) and then try to break things into small tasks. I just jot stuff down, then see if it truly relates to the problem. If it does, I keep it. If not, cross it out. On the tasks I keep, I write the date I completed it and a reference page number if I am keeping notes on the conversations.

So as an example:
1. Call power of atty, ask if they can handle for you( Not sure who your powered of attorney is - family member, friend, or appointed, so that may or may not be an option)
2. Call the NMSS - see if a navigator can help point you to any resources. Ask them if they can email you the information to help with your cognitive challenge. Ask if they can find an advocate to help you resolve the issue, help resolve your homeless situation, and also if know of any pro/bono legal services.
3. Start a list of non-profits in area to see if they can help (homeless coalitions, churches, habitat for humanity, etc...). Our church offers pro-bono civil legal services once/month for township residents who use the food pantry. So you never know who may be able to help.

Trying to understand why you have the huge infusion center bill if you kept your private insurance. Did you have large co-pays prior to admission?

I wish I had more to offer. Since things in storage, I am assuming you lost your house. Are you living temporarily with family or a friend, or are you on the streets?

Please keep us updated. You may also want to post in the general forum so it gets more visibility.

[oceanpride]

I think they take the blue cross money and make the rest of the charge go somewhere else. I know mine took all of my insurance coverage ($5000) bucks so I got no insurance now.
They got all kinds of tricks up their sleaves.
and some work to our advantage
But I don’t know how they do it.
Thry told me they were going to bridge it what ever that means Good luck.

[Kimba22]

I'm so sorry to hear about what you've been through and the surprise bill. You said that you still had your private healthcare, so were you enrolled in the co pay assistance program? If so, someone would've needed to inform the infusion center you had it before you had your infusions done. Perhaps it was never submitted to the program and/ or applied to your bill. It covers up to $20,000 annually for the drug and up to $1,000 for administration per calendar year ($1,500 the first year). I think you may still be eligible to use it retroactively if it was never submitted.

The infusion center I go to no longer does it for their patients, so I have do it myself. The program requires an itemized statement from provider, and the Explanation of Benefits from your insurance company. (Go here to upload the information: https://www.ocrevuscopay.com/). After it's approved and loaded onto my Ocrevus debit card, I use it to pay my bill. (You'll need your Ocrevus debit card to do this, so if you don't have it, you'll need to request a new one.) Call (844) MS-COPAY (844-672-6729) for assistance. I found some agents are more helpful than others, and had to call a few different times, to figure out what I needed to do. They can also tell you the dates of service it's been approved for, and how much they paid. This information can also be found using the website, but you'll need to call to get your username in order to set up an account if you're enrolled in the program.

Could the drug company help me retroactively?

Possibly. Reach out to them at 866-4ACCESS (866-422-2377) (6AM-5PM PST, Monday through Friday). https://www.ocrevus.com/patient/fina...e-options.html When I was on Tysabri, I got surprise bills after I got new insurance when the new year started. I can't remember now exactly what the problem was, but it was because the billing person was doing something wrong. I was billed the entire cost of 4 infusions. The infusion center reached out to the drug company (Biogen), and they offered to cover the cost of the drug (but not infusion costs). But, I pushed to get it covered under my insurance plan, and then could use the copay assistance program towards the cost of my deductible for the year.

I hope this information is helpful. I also hope your situation improves, and there are people willing to help you. Best wishes