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Someone should really tell you these kind of things!

cheatinlil's picture
cheatinlil
Posts: 194
Joined: Jun 2014

So my husband has been on chemo pills for 3 calendar years now.  Our insurance out of pocket maximum is $5700 per individual a year.   The COPAY for chemo pills is $3000 for a 30 day supply.  So we usually pay a month and a 1/2 then they are free for a year. I just found out they have programs that will help you pay for this.  I just paid $10 for a 30 day supply and it is good through 12/31/2016 which I won't need again because we already reached the out of pocket maximum.  Last month I paid the $3000  with my discover card (which is how I pay annually) since I wasn't aware of the program.  The requirements have nothing to do with annual income.  There were 4 questions.  I wish I wrote them down but I think it was 1) do you live in the US 2) do you have private insurance 3) are you prescribed the medication 4) can you be reimbursed by another means.  I printed a Pfizer Copay one saving program and called the pharmacy and gave them the info $10. Simple.  Why hasn't anyone ever told me that?  I wanted yall to be in the loop. 

I hope you are all doing well. My husband's Inlyta is working with less side effects than the last chemo pil.  We go back in August for scans.   

Jojo61's picture
Jojo61
Posts: 1310
Joined: Oct 2013

Wow, that sounds wonderful, CL!! I know it is frustrating to find out now....but at least better late than never! And glad that your husband is experiencing less side effects.

Keep us posted on his scans!!

Hugs

Jojo

BellaBinksMom's picture
BellaBinksMom
Posts: 78
Joined: Sep 2014

They certainly don't tell us these things or make it common knowledge.  Luckily, I only pay $50 per month for my Votrient, however, when I refilled it the first time with my specialty pharmacy, they told me about the program and that I could most likely get that $50 reimbursed each month.  Glad you found out - what a relief for you!

Allochka's picture
Allochka
Posts: 925
Joined: Nov 2014

3000 and 10 usd - a huge difference! Great that you discovered it ! Do not look back at money already spent - just imagine how easier it will be as of now!

NewDay's picture
NewDay
Posts: 273
Joined: May 2012

Cheatinlil,

I just had the same experience.  My insurance has a $6,500 out of pocket maximum.  I have been taking Inlyta for 19 months.  I always meet the OOP in February.  I filled my prescription in January at the cancer center, like always, but afterward got a call from CIGNA saying my insurance had changed and I now have to use the mail order pharmacy.  I have gotten calls from them every few months to try to get me to switch but there was very little difference in the copay so I stayed with the cancer center.  When the cancer center sent orders to the mail order pharmacy a couple of weeks ago for my refill, the pharmacy called me to arrange payment of the copay.  She said  it would $2,200 which I said was what I was expecting.  She said "Do you have your copay assistance card?"  I said "What's that?"  She said "You aren't signed up?"  I said no.  She said she would call me back.  When she did, she said that she signed me up and my copay would be $10 which I was very excited about.  After it sank in, I called CIGNA back and asked why nobody had ever told me about it and he said that not everyone knows about it and I got lucky and got somebody who did.  I'm trying to just let myself be happy that I know now but it is hard not be be upset about the thousands of dollars I wasted the last two years.

When I saw my doctor last week, I mentioned it and he said "That's weird.  All my patients are on copay assistance."  That now makes me wonder if maybe they normally help there patients get signed up and somehow forgot to tell me.

Apparently, there are other drug companies that offer such assistance on their drugs so now I know to ask, but good grief.

sierra28
Posts: 70
Joined: May 2014

cheatinlil,  I was lucky, my cancer cntter knew tat tere were programs ou there.  At first the parmcy wanted $320 a month and now with the grant I pay $0 co-pay for one year.  I start my first round of chemo next Wed. with  Sutent.

It is too bad that you were not informed.

Sierra 

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