Re: Obama's new Health Care plan and Medicare RX for PA meds and its affect on copay

[Guest guest]

Keva: nobody can answer questions at this point because there are no answers.

Three bills have been passed and two Committees (both Finance, as I understand

it) still have to do their jobs. There will be much negotiating before we can

even begin to understand how it might affect us - if, indeed, health care reform

does become a reality. FYI, however, Medicare already affects one's ability to

get co-pays paid by the drug companies. Because I am on Medicare, I am

ineligible for any of the financial assistance programs offered by Enbrel and

Humira (I assume Remicade, also) that you apparently enjoy. Believe me - I've

tried. But Medicare is one thing; the public option being discussed - if there

is one - will likely be different in many ways.

However, I seriously doubt that the use of such drugs will be limited . . . . .

.. I've heard Obama express a desire, however, to develop generic forms of the

biologics. However, I've already shared with the group some information on the

problems associated with that, i.e. because of the nature of these particular

drugs, it is literally impossible to develop a generic that is bio-identical.

The best that can be done is to develop one that is very, very close in

biological structure; but then the question becomes, does that generic have to

go through all the testing that the original drug went through? The Europeans

have decided yes but who knows what will happen here - or even what the correct

decision might be. Health care reform involves a whole morass of very

complicated issues.

If you have concerns, I would strongly urge that you contact your

Congressman/Senator. Just google their names and almost all of them have

websites that make it very simple for you to send them a message.

Joanna Hoelscher

[Guest guest]

 

Joanna,

 

You mentioned that you have Medicare but have no drug coverage through them.  Is

that right?

 

I also have Medicare but receive my meds, Humira included through my coverage

with them.

 

Do you not qualify for the part D coverage for meds or what?

 

Just curious.

 

Kathy

[Guest guest]

Everyone should qualify for Part D if they get Medicare but you have to

pay for it.

Celeste

[Guest guest]

Kathy: I have coverage through the Medicare Rx program but Enbrel still ends up

costing me about $4,000/year out of pocket. What I was referring to is the

fact that the programs that offer the biologics at greatly reduced prices are

not available to those on Medicare or Medicaid. For instance, when I was first

diagnosed, my doctor gave me a card that she said would allow me to get Enbrel

free for the first six months and then at a $75 co-pay for the next six months.

(I've heard that the manufacturer is normally willing to continue that subsidy

in some cases.) However, when I looked, it said clearly on the card that it

was not for people on Medicare or Medicaid. (I guess I look younger than I am

and the doc - who was new to me - didn't realize I was on Medicare!!!!) So, I

called the company and asked why. They said it was because Medicare wouldn't

allow it. I called Medicare - went clear to someone in the D.C. office and

transferred to higher ups several

times and ultimately was told they had no such regulation. So, I went back to

the company and started the whole round robin again to no avail. My niece just

started on Humira for ulcerative colitis and has good insurance coverage but

still gets it for $10 per injection through a program offered by the mfg. None

of these programs are available to those on Medicare or Medicaid.

I hope that clarifies.

Joanna Hoelscher

[Guest guest]

Kathy,

I think Obama will try to get an ammendment to include Biologics. I pray that

he will. I am one of the people that desperately needs health care. I am

divorced, unemployed ( I was laid off 2 yrs ago). I looked for a job for a year

until my arthritis got worse and I now have a pinched nerve and torn disk at

L5/S1. This disease has ruined my life. I now depend on family for housing and

food. My state will not give welfare or food stamps to single (child less)

unemployed folks. I got insurance through Assurant health but they will not pay

for pre existing conditions for a year. I basically have it in case I get into a

car wreck. I live in GA and our insurance commissioner/gov joined a lawsuit that

blocks the law's requirement to set up high risk insurance pools. I have filed

for SSDI and I am prepared to go off of Biologics. I will just beg my pain

clinic to give me a pain patch ect. This is counter productive because my joints

will be vulnerable. My health will probably become worse.

All of you that are republicans need to take my story to heart. I used to be a

republican. If you are laid off and become afflicted with cancer, heart

problems, diabetes, or autoimmune diseases you will find yourself in the same

situation. I worked hard for 20 plus years. I would like to get some of the

money that I paid to social security back. Believe me, If I could scrub floors I

would.

Beth