Guest guest Posted October 13, 2003 Report Share Posted October 13, 2003 > hi > i am not currently on xolair, but my doc thinks i may need it. does > the insurance pay for it, or have any of you had lots of problems to > get the insurance to pay for it. > > have also thought about starting on immunotherapy " allergy > shots " again too. > that can also decrease the IgE Ag levels but is not as quick as > xolair. > > have a great day > > matt Matt, My Doctor did all the ordering and filing for me. They used a servicd called " curascript " http://www.curascript.com/ Not all insurance companies will cover as much as mine did. I think that somehow Curascript did some haggling with them on the price because i was lucky enough to get all the injections of Xolair a month for only a 35.00 monthly copay. Considering that each injection costs 500.00, I really am grateful for my coverage. Hope this helps Doug Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 11, 2005 Report Share Posted January 11, 2005 , I have a United Healthcare POS plan and I had no problem getting approval for Xolair. I've had 4 shots so far. My doctor's office took care of all the paper work and getting the approval from United. Cathie > > > Hello to all, > > About a month ago I was approved by Humana for Xolair and started > taking shots at the end of December. Now the company I work for > changed to United Healthcare Choice Plus. Does anyone out there > have experience with them for Xolair approval? > > Thanks, > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 28, 2005 Report Share Posted October 28, 2005 Right now, and I mean things change rapidly in health care sometimes and stagnate at others, Xolair is not covered unless you have a supplement to Medicare. Alhough some supplements don't cover it if Medicare doesn't. Your Physician can buy the Xolair and bill it to Medicare that way, and they repay him. Most MD's don't like to fool with that because medicare takes their time to reimburse the physician, up to 180 days. Don't give up hope Ron. Never know what tomorrow holds. Pat --------------------------------- FareChase - Search multiple travel sites in one click. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 29, 2005 Report Share Posted October 29, 2005 Hi! You are exactly like me. Planning (and worrying ahead!) I am Canadian so i have no idea about the Medicare system in the US but I am hoping it is a bit less backwards than ours. Congrats on the pred taper! I am on 9.5 mg!!!! And about to negotiate a taper vacation from my pulmo so I can hang out here for a bit. __________________________________________________________ Find your next car at http://autos..ca Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 31, 2005 Report Share Posted October 31, 2005 It took me 2 1/2 years to get approved for medicaid and the lawyer didn't take a penny out until I was approved and he took it out of the first retroactive payment. So, it is good to get started on that. I have medicaid and it is a blessing for me. Also needymeds.com is a place to look into. I have a whole list I can send you. Drug companies will also help you. Hang in there....it's not easy. Hugs..a Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 1, 2005 Report Share Posted November 1, 2005 - A lawyer takes one and only one, lump sum which is his fee after the reward is given. Yours, Deborah Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 1, 2005 Report Share Posted November 1, 2005 Dear Ron: I am now on Medicare and they will pay for it but, you must get a doctor that will supply an bill (in other words lay out the money first and then be reimbursed afterwards). There are doctors out there willing to do this the sales rep. from my doctors office put me in touch with one, because my doctor was not willing to do it. It worked out fine I've been getting my shots through this new doctor for about four months now and Medicare has been paying it. Good luck. Kathy ronaldcrpntr <cowtrail@...> wrote: I have been getting the shots for approximately 7 months, am now self administering. I'm doing better but hoping that It will continue to get better and I can get off of Prednizone (I'm down to 10-mg daily), etc. I presently have two insurances, my copay is $45 a month. I will completely retire in three years, If the asthma does not take me out first! Does anyone know if Medicare covers Xolair, granted it is 6 years before I'm 65 but when/if I retire I have insurance options to consider. Ron Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 2, 2005 Report Share Posted November 2, 2005 Have you noticed a difference that is worth going through the shots? Carol Dear Ron: I am now on Medicare and they will pay for it but, you must get a doctor that will supply an bill (in other words lay out the money first and then be reimbursed afterwards). There are doctors out there willing to do this the sales rep. from my doctors office put me in touch with one, because my doctor was not willing to do it. It worked out fine I've been getting my shots through this new doctor for about four months now and Medicare has been paying it. Good luck. Kathy ronaldcrpntr <cowtrail@...> wrote: I have been getting the shots for approximately 7 months, am now self administering. I'm doing better but hoping that It will continue to get better and I can get off of Prednizone (I'm down to 10-mg daily), etc. I presently have two insurances, my copay is $45 a month. I will completely retire in three years, If the asthma does not take me out first! Does anyone know if Medicare covers Xolair, granted it is 6 years before I'm 65 but when/if I retire I have insurance options to consider. Ron Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 16, 2006 Report Share Posted March 16, 2006 I am covered by an HMO with a special pharmacutical rider. I found, as long as the doctors office is giving the shots the medical benefits come into play. Otherwise, if you want to give the shots to yourself it falls under the pharmacutical portion of the insurance coverage. This meant in my case, the medical portion of the insurance picked up 80% of the cost of the injection which with the cost of the injection being around $1200.00 meant I am paying $240.00 for each injection as compared to the 35% under the pharmacy plan which is $420.00. I have to have 4 injections/month which means my portion of the cost (medical side) is $1680.00/month. My insurance also has a copayment maximum of $1000.00 which means as soon as this is reached the insurance pays all medical costs at 100%. In short, I reach this maximum in the first 2 1/2 months of the year and the rest is paid by the insurance policy. It is a little difficult to come up with the $1000.00 so soon each year but looking at the bigger picture, with all my other medical costs from hospital visits, tests, etc. throughout the year this seems like the better way to go for now. I still have to pay for all the prescriptions at 35% since they are filed through the pharmacutical plan. I haven't been able to figure out a way to decrease this cost. If you know of any way to get prescriptions covered at less than this I sure would like to know. ________________________________ From: [mailto: ] On Behalf Of pipermandycricket Sent: Thursday, March 16, 2006 12:42 AM Subject: [ ] Insurance Hi Guys, I'm starting a new job soon and have the option of choosing an HMO or a PPO plan. Is one better than the other for getting Xolair fully or partially covered? Any advice is welcome. Thanks, Joe Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.