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How to find coverage for Aubagio upon retirement that doesn’t break the bank?

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    How to find coverage for Aubagio upon retirement that doesn’t break the bank?

    Due to retire in August at the age of 66. Was diagnosed with the “Monster” at age 59 and have done well. On Aubagio 14 mg. PO daily. Problem...finding Part D insurance coverage for the drug in Texas without paying $1500 out of pocket monthly. Any information would help. Have signed up for part F but does not have drug coverage. Any retirees out there would love to hear from you.

    #2
    I found this from MSAA and maybe it can help you?:

    MS One to One will assist patients in the following ways:

    Individuals with no insurance, or with only Medicare part A and B (but not D), may register for the Patient Assistance Program (PAP). Eligible individuals must be a United States resident with a Social Security number. The household income must also be less than or equal to $100,000. If qualified, the eligible individual will have no out of pocket expense. Program participants must reapply each year. As noted earlier, individuals with Medicare part A and B may apply for assistance; individuals with part D are not eligible.
    For individuals with private insurance, co-pay assistance is available. If eligible, the applicant will receive the first three months at no cost. For every month thereafter until 12 months, the co-pay is $35. Program participants must reapply each year. Although there is no financial limit for income, only individuals with private insurance may apply.

    *Patients covered by federal and state healthcare programs are not eligible for assistance (excluding individuals on Medicare without part D who are otherwise eligible under the PAP program).

    https://mymsaa.org/ms-information/pr...ion-assistance

    Good luck!
    1st sx '89 Dx '99 w/RRMS - SP since 2010
    Administrator Message Boards/Moderator

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      #3
      Thanks for that info!!!!! Makes me wonder if I need to get part D coverage, as the MS medicine is all I am on. I appreciate the quick response.

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        #4
        You're welcome, although there is a catch! You will get penalized for not signing up for Part D coverage at the time of retirement.

        The Part D late enrollment penalty is explained here: https://www.medicare.gov/part-d/cost...t-penalty.html

        Of course it inevitable that as we age we will probably need more meds, so this can be tricky on your part on deciding what to do.
        1st sx '89 Dx '99 w/RRMS - SP since 2010
        Administrator Message Boards/Moderator

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          #5
          Hi Becky.
          My husband just retired. I was very worried about my out of pocket costs for my copaxone. I opted for traditional Medicare along with part d drug coverage from silverrscript and a supplemental policy from aarp. That still would have left me with large out of pocket drug costs. There are foundations that pay these costs.

          I received a grant from the Health well Foundation which covers my copaxone copay for the year. The Pan foundation also offers these grants. You can apply for these grants on line.
          Good luck!
          Eileen

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