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  • montanagirl10
    replied
    Originally posted by durgastiger View Post
    Try i-core pharmacy.
    What kind of insurance do you have?
    My husband's co. is "the ins. co." and the claims are managed by United Healthcare. So his employer decides what they will pay for, etc. They are not easy to deal with and do not "want" to pay claims. I am playing the waiting game.

    Leave a comment:


  • meburnett2004
    replied
    It just depends on your prescription plan with the insurance company. I unfortunately had a horrible plan that ,akes me pay 100% for tier 3 & 4 drugs. Like really BCBS who can afford those kind of drugs!!!

    Leave a comment:


  • Willow63
    replied
    Originally posted by Remy9111 View Post
    Remember that even within one state and the same insurance company, your benefits could vary. A lot of it can depend on your employer and what particular "benefits" the employer choose for your particular plan -- different deductibles, different tiers and prices etc.
    So true! I have a BCBS policy and Tecfidera is covered with copay.

    Leave a comment:


  • Rsqwyr
    replied
    I have BCBS of Texas as well. My neuro is going to start the process this week to get me approved. It was almost impossible to get them to cover Copaxone! Can't wait to see how long this takes. We did new MRIs of brain and cspine last week which showed progression from a year ago so maybe they won't be too bad (wishful thinking).

    Leave a comment:


  • meburnett2004
    replied
    Hello I also have BCBS (hate them). My plan required me to pay 100% copay of the drug. Therefore I couldn't pay for it. I battled with the insurance company and informed Biogen and MSactive source. FInally after two weeks, Biogen/Active source approved me for the drug for free for 12 months. Dont give up just keep up with Biogen. Biogen had to verify that BCBS is in fact making pay 100% responsible for the drug. When they found out that was true , Biogen approved me for free They've been wonderful.

    Leave a comment:


  • Remy9111
    replied
    Remember that even within one state and the same insurance company, your benefits could vary. A lot of it can depend on your employer and what particular "benefits" the employer choose for your particular plan -- different deductibles, different tiers and prices etc.

    Leave a comment:


  • laurasari
    replied
    I was so surprised. It took 1 month to get approval for Aubagio and 1week for this new med. I was told the 10 dollar copay would last 1 year. The same day I had to see my neuro. And was shocked when he was no longer thrilled with me starting this med so I am back on aubgio for 2 days if I get my headaches back I have to go back on Gilenya which was fine though I could not stay on my beta blocker. Which I very much need.

    Leave a comment:


  • durgastiger
    replied
    @Montana Girl

    Try i-core pharmacy.
    What kind of insurance do you have?

    Leave a comment:


  • montanagirl10
    replied
    Originally posted by Sunshine View Post
    According to the Tecfidera booklet that was given to me by my Neuro and I got one from the company as well, says on page 12 under Active Access: "With the Tecfidera $10 co-pay program, *you pay just $10 a month for your treatment. This program includes:

    -No income recquiremet- regardless of your income, you can enroll
    -No time limit-you can re-enroll every year
    -No waiting- your speciality pharmacy can enroll you immediately into the program so you can get Tecfidera right away

    Co-pay details and eligiblity includes:
    *please note that for the $10 co-pay Program, cost per month assumes One box of Tecfidera containing 30 days dose. You are
    eligible to enroll as long as you are treated with Tecfidera.
    * Federal and state laws may prevent eligiblity. People covered by Medicate, Medicaid, the VA/DoD or any other federal plans are not eligible to enroll. If any of these wpply to you, please asknMS ActiveSourse for information about charitable program that may help with the cost."

    Hope this helps. For more info check out thier website. I will say that I am still waiting, because BCBS of NC requires preautherization...thats not included in the small print

    I just enrolled in this copay assistance with Biogen and was also told it will only cover $10,000.00 max yearly in copay assistance. So you pay the $10 and they cover the rest of the copay, but only up to $10,000 annually. Kind of a bummer since it is not my ins. formulary yet, and if it does not get put on there I can only expect about 5 months of copay assistance and then I can not afford this medication. Hope this stuff with ins. co. get worked out soon.

    Leave a comment:


  • Mkc3031
    replied
    I'm in NY-BCBS is covering my tecfidera. And with tecfidera $10/month copay. Hope it works out for everyone who wants to try this drug

    Leave a comment:


  • ms man
    replied
    Originally posted by LilStep View Post
    Just found out today that my insurance co. doesn't want to cover Tecfidera. Called Biogen and they said they are trying to figure out what they can do to help.

    I hate insurance companies. Another waiting game for me...blah.

    Has anyone had this problem yet? I have Blue Cross Blue Shield of Texas.
    Health care companies are a horror.I too have Black and Blue Cross ( as I affectionately refer to them).Do they cover Tysabri?

    Good luck and keep us posted.

    Leave a comment:


  • rdmc
    replied
    Originally posted by Sunshine View Post
    According to the Tecfidera booklet that was given to me by my Neuro and I got one from the company as well, says on page 12 under Active Access: "With the Tecfidera $10 co-pay program, *you pay just $10 a month for your treatment. This program includes:

    -No income recquiremet- regardless of your income, you can enroll
    -No time limit-you can re-enroll every year
    -No waiting- your speciality pharmacy can enroll you immediately into the program so you can get Tecfidera right away

    Co-pay details and eligiblity includes:
    *please note that for the $10 co-pay Program, cost per month assumes One box of Tecfidera containing 30 days dose. You are
    eligible to enroll as long as you are treated with Tecfidera.
    * Federal and state laws may prevent eligiblity. People covered by Medicate, Medicaid, the VA/DoD or any other federal plans are not eligible to enroll. If any of these wpply to you, please asknMS ActiveSourse for information about charitable program that may help with the cost."

    Hope this helps. For more info check out thier website. I will say that I am still waiting, because BCBS of NC requires preautherization...thats not included in the small print
    Thanks, sounds good unless you're on a gov't insurance plan. I don't understand that logic. Those on SS disability are on Medicare..so that cuts out a good number of MS patients. Is Medicare going to cover it, I'd assume they were after reading the info from that brochure.

    Leave a comment:


  • KatW
    replied
    I have BCBS Texas and supposedly have been approved. I have no drugs yet. It is currently being held up at Accredo waiting for faxes for copay assistance. So, I'm still waiting too.

    Leave a comment:


  • Sunshine
    replied
    According to the Tecfidera booklet that was given to me by my Neuro and I got one from the company as well, says on page 12 under Active Access: "With the Tecfidera $10 co-pay program, *you pay just $10 a month for your treatment. This program includes:

    -No income recquiremet- regardless of your income, you can enroll
    -No time limit-you can re-enroll every year
    -No waiting- your speciality pharmacy can enroll you immediately into the program so you can get Tecfidera right away

    Co-pay details and eligiblity includes:
    *please note that for the $10 co-pay Program, cost per month assumes One box of Tecfidera containing 30 days dose. You are
    eligible to enroll as long as you are treated with Tecfidera.
    * Federal and state laws may prevent eligiblity. People covered by Medicate, Medicaid, the VA/DoD or any other federal plans are not eligible to enroll. If any of these wpply to you, please asknMS ActiveSourse for information about charitable program that may help with the cost."

    Hope this helps. For more info check out thier website. I will say that I am still waiting, because BCBS of NC requires preautherization...thats not included in the small print

    Leave a comment:


  • Alpharetta
    replied
    Copay Assistance

    Ampyra has a copay assistance program that gives me my month for $40, Biogen's program gets you the med for $10. They don't say if it is temporary or what, but Axom gave it to me for $10, CVS is going to $300 until they confirm with biogen.
    When i spoke to my pharmacy they were quick to point out that this med costs $9,000 a month, you never know what that number means so i take it with a grain of salt.

    Leave a comment:

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