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Question..do you live in " the states " or Canada?!

________________________________

From: Carol Corley <floridabouvs@...>

Sent: Thursday, March 3, 2011 1:05 PM

Subject: [ ] Assistance question

I have been sent paperwork for the Xolair assistance program since my co-pay

went up to $850 every 3 months. They require an income and savings statement,

and I'm afraid I'm going to end up being one of those people who has too much

money to justify assistance, but not enough money to be able to afford the shots

-- the Middle Class squeezed from all directions.

My husband and I just retired this year, and they want last year's tax return

from when we were both employed full-time. Now retired, we count on our IRA

money to live on.

Does anyone have an idea how this all works? How restrictive are they in

considering savings?

Thanks,

Carol

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I live in the States.

Carol

Question..do you live in " the states " or Canada?!

____________ _________ _________ __

From: Carol Corley <floridabouvs>

Sent: Thursday, March 3, 2011 1:05 PM

Subject: [ ] Assistance question

I have been sent paperwork for the Xolair assistance program since my co-pay

went up to $850 every 3 months. They require an income and savings statement,

and I'm afraid I'm going to end up being one of those people who has too much

money to justify assistance, but not enough money to be able to afford the shots

-- the Middle Class squeezed from all directions.

My husband and I just retired this year, and they want last year's tax return

from when we were both employed full-time. Now retired, we count on our IRA

money to live on.

Does anyone have an idea how this all works? How restrictive are they in

considering savings?

Thanks,

Carol

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The problem is that I'm retired and on a Medicare Advantage plan, and the credit

card is not available for people like me. It's for the squeezed uninsured or

working middle class, not the squeezed retired middle class.

The income statement that I must fill out includes any assistance from family

and friends -- not that I am getting any, but it sort of lets me know that they

will scrutinize any income and savings very critically.

Which means I doubt that I will qualify, and therefore will have to stop Xolair,

which has been very successful for me. My copay has gone from $30 every 3

months, to $200 every 3 months, to now $850 every 3 months. It's the last bump

that puts me out of the picture.

Anyway, thanks for your replies and suggestions.

Carol

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I suspect getting finacial help for Xolair as a senior is like walking through a

mine field. So I offer advice that may or may not hold true ... my

understanding is that there are two types of assistance. The first is if you

don't have insurance and need help paying for the whole cost. The second is if

you have insurance but need help with the co-pays.

And it's my understanding (though poorly founded) that when you need help for

the entire cost, because you don't have insurance, you have to jump through

hoops and divulge your entire financial soul but if you are going the co-pay

assistance route the hassels are much less.

Look at it this way ... IMHO the pharmaceutical companies are out to make money,

not keep you from going broke. So they want paid (fair enough). Now if you

have no insurance, they want you to cough up your life savings if need be. If

you're truly broke, they may help you with the whole cost. Otherwise, they want

your money. But if you have insurance, they're happy with the insurance money,

and if helping you with the co-pay opens the insurance money valve, they'll step

in to help with less hassle.

Now I also understand that there are organizations set up to help you with

co-pays only and they are funded by donations from the pharmaceutical companies

(please, no flames if I've got this wrong). They will not help the un-insured,

only the insured that struggle with co-pays. These independent organizations

are not required to favor the products of any particular pharmaceutical company

but you don't think they're going to bite the hand that feeds them, do you

(again, please, no flames)?

So if you have insurance, try applying to a third party organization that helps

with co-pays. Ask your primary drug insurer, which is probably a specialty

pharmacy in the case of Xolair, who they recommend you go to for help with

co-pays.

Both the pharmaceutical company and the pharmacy want you to be funded for this

expensive medication because if not, and you can't afford it, or just won't pay

for it, they lose the sale and you lose treatment. That's a lose-lose

situation. So harness our great capitalistic system to work for you and

hopefully get you the treatment you need.

And I appreciate anyone else helping me to clarify and/or correct everything

I've said, because like I say, we're probably walking through a mine field.

Finally, I also understand medications like Xolair can be handled in some

situations as a pharmaceutical (ie a drug), whereby you attempt to get your drug

insurance plan to pay, and there may be situations where Xolair is handled as a

treatment, like chemotherapy, whereby you attempt to get your medical insurance

plan to pay. So if one approach isn't working, try to take the other approach.

Be your own advocate and discuss these two approaches with your doctor and your

insurance sources.

I really hate to see seniors (or anyone) be denied Xolair because they can't get

good jobs with good medical insurance, or have to cough up their limited life

savings because of the Medicare donut hole, so lets keep this thread going with

peoples' experiences navigating through the Xolair cost mine field.

I have a vested interest in this because I'll probably soon go on Medicare and

there's no way I afford getting thrown into the donut hole with Xolair. I'll

have to throw in the towel and go back to suffering and struggling to breath and

hit prednisone big time and hang out at the ER with broken bones.

>

> I have been sent paperwork for the Xolair assistance program since my co-pay

> went up to $850 every 3 months. They require an income and savings statement,

> and I'm afraid I'm going to end up being one of those people who has too much

> money to justify assistance, but not enough money to be able to afford the

shots

> -- the Middle Class squeezed from all directions.

> My husband and I just retired this year, and they want last year's tax return

> from when we were both employed full-time. Now retired, we count on our IRA

> money to live on.

> Does anyone have an idea how this all works? How restrictive are they in

> considering savings?

> Thanks,

> Carol

>

>

>

>

>

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$1250 a vial?! Is anyone else paying that much? I thought it was $500 a vial.

>

> Hi Gwen,

>

> Sorry to hear about your delimina.. :(

>

> Can I ask how high your IgE was? If you're taking 3 vials every 2 weeks,

> that's 3X the amount I am taking. I have 2 vials per month... at a cost of

> $1,250 for each vial. Xolair is paying 80% of my deductible (which is

> $150.00)... I pay $30.00 per visit along with the $50.00 co-pay for the

> specialist office visit so my payments are $80.00 per month.

>

> I had my first injection 2 weeks ago and was almost completely hive free

> right after. Now the hives are coming back. I'm wondering if I need to have

> the injections every 2 weeks.... but my physician said my IgE wasn't high

> enough ALTHOUGH Curascript (my speciality pharmacy for Xolair) already

> shipped the next 2 vials to my doctor!

>

> Best of luck to you!!!!!!!

>

> xo,

>

> shannon

>

>

>

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