Insurance Won’t Cover Revlimid - HELP

lmbreen91

Hi, 

My aunt has been taking Revlimid for 4 years now. It has been covered this entire time, but this past month the insurance company stopped covering it. The doctor has completed and appeal. My aunt has appealed. The doctor completed a peer to peer. The insurance company just will not cover it. They also will not tell her what comparable drug is covered under the plan. The drug is $14,900 without insurance, so it's not like she can pay that out of pocket. She currently is insured through Maryland Medicaid and Maryland Physician Care.  

I have emailed the health commissioner, no response. We have contacted the manufacturer of the drug via phone and a financial assistance form, no response. 

Does anybody have any experience with dealing with the insurance company / how to get this covered? It's obviously medically necessary. I just need some information / pointing in a direction. I feel like everything we have done has been met with a dead end. 

Thank you. 

br_bernardo

Sorry I don't have any

Sorry I don't have any specific advice (other than maybe try a lawyer??) but I do pray for your aunt I know it's not easy when they stop covering an expensive medication.

jest5471

https://csn.cancer.org/discussion/comment/1685280#Comment_1685280

https://csn.cancer.org/discussion/323075/insurance-won-t-cover-revlimid-help

Try contacting the Leukemia & Lymphoma Society, I am taking Revlimid and they will help with paying the cost and other bills associated with cancer. ( lls.org )

Kindra

Have you talked to Social Worker at the hospital you go to they some times have grants to cover chemo’s that aren’t covered by insurance.

I am in Fl on Medicaid and Medicare and a supplement and they cover Revimid.

Harry_M

Imbreen91 do you still need help with your aunt. I may be able to help

jest5471

https://csn.cancer.org/discussion/323075/insurance-won-t-cover-revlimid-help

I take Revlimid and my medication is taken care of by the Leukemia & Lymphoma Society go to their website and apply for help and they pay for the medication every month, also they offer help with other cancer related issues, this is the best thing I ever did since I started treatment.

DLowe

lls.org

paf.org

Hi I am new here but there are several foundations that cover all the medications for cancer

patient advocate foundation

LLS.org

and several others look those up and I hope they help God bless your family

cs60

The drug companies can help cover some of those costs- Call the specialty pharmacy that you use, they can help get that set up for you hopefully.

Dawner7417

https://csn.cancer.org/discussion/323075/insurance-won-t-cover-revlimid-help

When I first started on Revlamid I didn’t have insurance. My doctor filled out for me to revive it free from Bristol Myer Squib. Now that I have insurance I and my doctor have filled out for co-pay assistance program. Just get with the doctor and contact Bristol Myer Squib. I hope they can help.

jest5471

You can also contact lls.org and inform them of your circumstances and they will send you a prescription card to help pay for the Revlimid. Also try and request a prescription from your doctor for Lenalidomide this is the generic version for Renlimid, one other thing to try is to contact Onco 360, this is a oncology pharmacy who may be able to assist you with other payment options. Good luck.

MJKkpk

Our insurance didn't cover it and it was 17,000 a month. We were lucky to get into a grant for the medication. See if your Dr can find one for you.