Pay for Gleevec

[Guest guest]

Dear Pete,

Yes, we pay for our own meds. If you have insurance that covers your meds,

then you only have to meet the co-pay. There are several organizations that

help you with the payment or pay for all of it, depending on your income.

Medicare would not cover it, since it is oral; however if it was an infusion,

they would pick up 80% and your secondary insurance would pay the other 20%.

Some organizations deal specifically with cancer and LLS helps you find someone

to help you pay for CML drugs.

You are not ignorant, Pete, how would you know, just as we don't know how

your system works. Where are you from and how does yours work? Not every

country with socialized medicine picks up the tab for your meds and you also

have to pay for your insurance. Maybe some of our members could explain their

system and then we would understand how everyone has to deal with the problem.

I am over 65, so I am in the Medicare system which pays 80% with my

secondary insurer picking up the other 20%. However, that does not pay for my

meds. We on Medicare are qualified to get into what is called a Plan D. Quite

a few pharmaceticals participate, but not in all states. You have to look up

the one for your state and see what each one offers as their formulary, such as

the class of drug and they will pay a percentage. The tiers are all different

and it takes a Philadelphia lawyer to figure it out. If it is a common generic

drug, you may not have to pay anything, and some charge a co-pay. For instance

if something is $129, I may have a small co-pay as long as it is generic.

However, the little fly in the ointment is a TrOOP Limit (it gets

complicated here) and once you have reached the level of $4,050 out of pocket

expenses including your Plan D and your payments, you would be in Catastrophic

Coverage phase and would only be liable for 5% of the cost. In January, you

begin another calendar year and go back to paying the initial coverage limit of

$3,715.53. After that time, you would pay full price for all of your drugs

until you reach the TrOOP level of $4,050. I know, it's as clear as mud.

Walmart and the big super drug stores have begun to offer generic drugs for

$4.00 and Publix super markets which are located in Florida and a few other

southern states give them free. How I wish I lived in Florida. LOL.

Blessings,

Lottie