Will my Insurance or Medicare pay for MS meds?

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sueg
Veteran Member


Date Joined Aug 2013
Total Posts : 718
   Posted 10/25/2013 11:30 AM (GMT -6)   
I have no dx of MS but am curious if it is hard to pay for the meds for MS? I have been reading online how some insurance cos. will not pay for MS meds. I have Medicare and a private Insurance but still I wonder? And I read that if coverage is denied then a Dr. can possibly intervene? And can you just not take any medicine?
 
Thanks for your answers, especially Gretchen...
 

Gretchen1
Forum Moderator


Date Joined Jan 2007
Total Posts : 3565
   Posted 10/25/2013 4:41 PM (GMT -6)   
I can't really say on this one. I am double insured via my work and my husbands work. I know that most MS meds range from $3,000 - $10,000 a month.

I believe copaxone is $3,200 a month.

MS is extremely expensive. 5 days of IV solumedrol for an acute exacerbation can run $12,000.

I've always assumed that there could be a chance that I can't afford treatment some time in the future. So far I've been lucky.
Diagnosed with MS July 2006

I have no lesions on my soul and so I live with no limits.

sueg
Veteran Member


Date Joined Aug 2013
Total Posts : 718
   Posted 10/25/2013 11:19 PM (GMT -6)   
So then do some people only need a more mild form of treatment?

And possibly less expensive?

How does the Neuro doc determine what would be effective?

Do some people not need any medicine?

Thanks for all your answers!

Gretchen1
Forum Moderator


Date Joined Jan 2007
Total Posts : 3565
   Posted 10/26/2013 8:50 AM (GMT -6)   
Some people decide to treat their MS by making food and lifestyle changes. This may be due to the high cost of the meds or because most of the treatments come with side effects that can be hard to manage. There is also no real guarantee that a med therapy works all the time for everyone. MS is a very poorly understood disease. The treatments are all relatively new and non of them stop the progression. They attempt to slow it down. MS tends to march on despite this. I have been on copaxone for seven years. I still have symptoms to manage every day. I still have ocossional exacerbations. I do feel it has helped though, but I can never really be sure.

There are no cheaper treatments that I know of. Some of the drug companies have assistance programs for people who can't pay for their meds or their co-pay costs.
Diagnosed with MS July 2006

I have no lesions on my soul and so I live with no limits.

gimp79
New Member


Date Joined Jul 2011
Total Posts : 16
   Posted 10/26/2013 12:57 PM (GMT -6)   
paying for ms. medications....there is help..there is the chronic disease fund which helps with paying for medication....then the companies that make the drugs have programs that will help pay ... there is help.........barb

Rangie32
New Member


Date Joined Nov 2013
Total Posts : 4
   Posted 11/15/2013 1:57 PM (GMT -6)   
I'm not sure what med your nerologist is wanting to put you on, but I was diagnosed 2 weeks ago and my Dr. feels that Capaxone will be the best fit for me. I have insurance, but it is not the best. Well my dr. gave me the information packet and told me to contact the drug company. Inside the packet was a pamphlet about a program the drug company has. They called and worked with my insurance company so my Capaxone is only going to cost me $35 a month. Without insurance I believe it is around $3,000 a month and normally my insurance company would require me to pay 10% of that, so calling the drug company was well worth my time. They were very nice and very helpful. Not to mention I didn't have to deal with my insurance company at all, the drug company did it for me.
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