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    4-ap and Medicare

    When Ampyra was denied for me, I switched to 4-ap. I've been paying for it myself, but am trying to get my Medicare plan to pay some of the cost. It was denied because Medicare doesn't cover bulk powders. I can appeal their decision, saying why I need this medicine, and that it has to be compounded with bulk powder, but I wonder if I'm wasting my time. My insurance does cover some compounded medications, and I have found compounding pharmacies that are in network. Any ideas? Thanks.

    #2
    Originally posted by nkh18 View Post
    When Ampyra was denied for me, I switched to 4-ap. I've been paying for it myself, but am trying to get my Medicare plan to pay some of the cost. It was denied because Medicare doesn't cover bulk powders. I can appeal their decision, saying why I need this medicine, and that it has to be compounded with bulk powder, but I wonder if I'm wasting my time. My insurance does cover some compounded medications, and I have found compounding pharmacies that are in network. Any ideas? Thanks.
    I’m also on Medicare and made the switch to 4Ap. Since I was paying $40 for Ampyra and $40 for 120 capsules of 4AP, I figure it all evens out. A generic Ampyra will be available January 23, I believe, so that might be an option.

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      #3
      Originally posted by ru4cats View Post
      I’m also on Medicare and made the switch to 4Ap. Since I was paying $40 for Ampyra and $40 for 120 capsules of 4AP, I figure it all evens out. A generic Ampyra will be available January 23, I believe, so that might be an option.
      I'm getting mine from Skip's Pharmacy now for $46.90. I haven't found anything close to that amount. Where do you get yours? You made a good point about about paying out the same amounts for Ampyra and 4-ap. My co-pays with Ampyra were a lot more expensive, so maybe I should just be happy with 4-ap and the cost. It frustrated me that my insurance wouldn't cover a medicine that 2 doctors had deemed helpful for my MS weakness. Thanks for your input.

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        #4
        Originally posted by nkh18 View Post
        I'm getting mine from Skip's Pharmacy now for $46.90. I haven't found anything close to that amount. Where do you get yours? You made a good point about about paying out the same amounts for Ampyra and 4-ap. My co-pays with Ampyra were a lot more expensive, so maybe I should just be happy with 4-ap and the cost. It frustrated me that my insurance wouldn't cover a medicine that 2 doctors had deemed helpful for my MS weakness. Thanks for your input.
        I get mine from Skips also, but I go for two months at a time and save one shipping cost. I’m actually much happier with 4Ap, and I know the generic Ampyra will be much more.

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          #5
          Thanks, ru4cats.

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            #6
            ru4cats: Please, where did you find this information about 23.1.? I have googled the internet and still did not find any info about some generic Ampyra neither the price.

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              #7
              Originally posted by PeterX View Post
              ru4cats: Please, where did you find this information about 23.1.? I have googled the internet and still did not find any info about some generic Ampyra neither the price.
              I found it at drugs.com under generic Ampyra availability. Activis labs and aurobindo gave an approval date of Jan. 23. I did read elsewhere it might take until July to ramp up production. No cost, yet, that I could find.

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