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Multiple Sclerosis Community
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Insurance comp woes

My daughter was dx a couple of months ago. Initially  dr prescribed Gilyenia and it was denied by insurance. Then he submitted Copaxone 40. It has been over 3 weeks and we got word today that it also was denied. Shared solutions couldn't tell us if they may perhaps approve the Copaxone 20. I'll be calling the dr in the morning. This is frustrating. I know this prob pretty common but I hate that the insurance is limiting what meds a patient can take. And we have good insurance, or so we thought. You too???
2 Responses
1831849 tn?1383228392
Hi MBHB -

Having MS is not cheap! Even with pretty good insurance It can be very expensive. I'm on Rituan. MS is an off label use of rituxan, so most insurance won't pay. Mine does pay and my out of pocet for rituxan alone is close to $5,000/year!

I'm hearing a lot of insurance company push back on the new dosing of Copaxone. Hopefully they will cover the old dose. It looks like Teva has some co-pay assistance programs, which I'm sure you've researched.

Kyle
11305938 tn?1417998533
My tysabri is $4500 for aan hour infusion once a month. The trillium and the drug company both pay for it. I am not sure Hoow it works but am so thankful it does. I basically had no income or $ coming in for the past two years and it shows on my income tax statement. Thank goodness my parents could help me out. They even paid my rent in my own apt or else their income statements wouldd have been analyzed.

Any little change and I might not be able to get my meds. Thank goodness while I. Was sick I wasn't able to nurse and was part time, therefore didn't have benefits. If I did I wouldn't have been able to afford it. Crazy how things work when it comes to medicine that keeps me from relapsing!
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