Guest guest Posted June 22, 2005 Report Share Posted June 22, 2005 --- In , " kathyh1942 " <kathyh1942@y...> wrote: > Dear Folks: > > I've been getting xolair shots for three months and I'm really doing > well. I've been trying to get S.S. disability for two years now. > Well it I got it and they sent me my Medicare card. Medicare will > pay 80% of the xolair and my insurance will pay the other 20%. The > problem is Medicare says it has to be supply and bill. Which means > the doctor would lay out the money and Medicare would reimburse him. > The doctor isn't willing to do this (I don't blame Him) because, > Medicare takes it's time in paying their bills. > > My pharmacy would do the supply and bill but, the Xolair cannot be > sent to the pharmacy. It can only be sent to a hospital and > hospitals are not willing to lay out the money. The vendor who was > sending the Xolair to my doctor will only send it if it can bill an > insurance company or Medicare. The insurance company is out of the > picture now because their not my primary now. > > Does any one have a solution? > > Thanks a lot, > > kathy Kathy, Go ahead and have it sent to your doctor. Explain to him that you will absorb Medicares slow payment history by covering it yourself, until he is reimbursed. In other words, pay the doctor a couple of injections upfront. Also, call Novartis. I believe they have a service that helps with the funding of the shots. They can possibly talk the lab into waiting for their payment...so they do not have to bill the doctor right away. I've noticed that Novartis has been very creative with helping people get on their product. It's in their best interest. Best of luck...Jay Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 22, 2005 Report Share Posted June 22, 2005 Hey Kathy, The only other solution is for you to ask your Primary Care Provider, another allergist or pulmonologist in the area. Medicare takes up to 6 months to pay and physicians don't want to wait for their reimbursement. Sorry to hear of your trials and tribulations. Everyone I speak to from my pharmacy seems to be doing very well on Xolair. Few have the headache & body aches for about 8 weeks, but all are breathing better & after a while using less or no medications especially prednisone! If you can find no one to buy & bill, ask the prescribing physician for the phone number to the representatives for Genentech or Novartis. The companies have a program for people who can't afford their meds. Maybe they could help with the medicare issue. Pat __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 22, 2005 Report Share Posted June 22, 2005 Kathy, Please let let me know what you find out. I have been getting two shots every two weeks since November . I feel good and want to continue the Xolair. However, like you, it is costing me about $220 every two weeks. For a long time I was getting the shots at Optioncare. Medicare would not pay for it there but my secondary insurance would pay 80% and I pay the rest. Then my doctor said she would get it and I've been getting it at her office. However, she is buying the Xolair through Optioncare and I'm paying just as much! She doesn't charge me as much for the injection, but she is paying more for the medication. I, too, am looking for a solution and would appreciate any help. Thanks so much, Carol in Ohio ----- Original Message ----- From: kathyh1942 Sent: Tuesday, June 21, 2005 5:07 PM Subject: [ ] xolair Dear Folks: I've been getting xolair shots for three months and I'm really doing well. I've been trying to get S.S. disability for two years now. Well it I got it and they sent me my Medicare card. Medicare will pay 80% of the xolair and my insurance will pay the other 20%. The problem is Medicare says it has to be supply and bill. Which means the doctor would lay out the money and Medicare would reimburse him. The doctor isn't willing to do this (I don't blame Him) because, Medicare takes it's time in paying their bills. My pharmacy would do the supply and bill but, the Xolair cannot be sent to the pharmacy. It can only be sent to a hospital and hospitals are not willing to lay out the money. The vendor who was sending the Xolair to my doctor will only send it if it can bill an insurance company or Medicare. The insurance company is out of the picture now because their not my primary now. Does any one have a solution? Thanks a lot, kathy ------------------------------------------------------------------------------ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 4, 2005 Report Share Posted December 4, 2005 Well I am a candidate for xolair. Now all I have to do is seewhat my insurance says.. The waiting begins... Sharon in westminster Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 13, 2006 Report Share Posted January 13, 2006 Hi Deborah The best web site is from the drug company: www.xolair.com I know what you mean about pred. I look about 5 months pregnant and like you, tiny legs and no butt. That is what pred does, it moves your fat deposits around (and makes you eat too...) Check out www.webmd.com there is an adult asthma support board which some of us belong to. Good bunch of compassionate people who understand what this is about. Welcome! __________________________________________________________ Find your next car at http://autos..ca Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 13, 2006 Report Share Posted January 13, 2006 hi deborah, it sounds like you've dealt with your fair share of resp. problems. to answer your questions, xolair is an injectable medication to help control (moderate - severe) allergy induced asthma. you can learn more about it here -- http://www.xolair.com/index.jsp . there's a few people here who have allergy induced asthma and were treated with daily prednisone as you are, and experienced the same blood sugar issues. i'm sure they can share their story with you. i've had bad allergies all my life. allergy shots were not an option for me because of the degree of my allergies. for me, xolair has given me back my life. i haven't been on prednisone for an asthma flare in over a year (YEAH). before xolair, i was on prednisone tapers more than i was off. i still have asthma problems, but none as severe as my pre-xolair days. good luck. let us know what your dr says. heather this is cut/pasted from xolairs site -- http://www.xolair.com/patient/xpansions_newsletter3_9.jsp Who is XOLAIR For? XOLAIR is a prescription medicine given by injection for people who: Are 12 years of age and above Have moderate to severe persistent asthma Have asthma that is triggered by year-round allergens in the air, which is confirmed by a doctor using skin or blood test Continue to have asthma symptoms even though they are taking inhaled steroids. Adding XOLAIR to treatment with inhaled steroids has been clinically proven to help reduce the number of asthma attacks. XOLAIR has not been proven to work in other allergic conditions. " There is a time in every man's education when he arrives at the conviction that envy is ignorance; that imitation is suicide; that he must take himself for better, for worse, as his portion; that though the wide universe is full of good, no kernel of nourishing corn can come to him but through his toil bestowed on that plot of ground which is given to him to till. " -- Ralph Waldo Emerson --------------------------------- Photos – Showcase holiday pictures in hardcover Photo Books. You design it and we’ll bind it! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 13, 2006 Report Share Posted January 13, 2006 Welcome to our group Deborah! I hope your physician prescribes it for you. If not, find another physician. How are you taking the Spiriva, Albuterol and Combivent? Did your physician tell you not to take them together? This worried me in your note. Spiriva should not be taken with combivent. Albuterol is part of combivent, so they should not be used together either. Please contact your physician and ask them to write out a medication regimen for you. You'll need to stay on all of your meds with Xolair for some time. When you start feeling better your physician will tell you when to stop some of your meds or cut them back. As for the sarcoidosis, it probably won't help it. But, controlling the asthma will make it easier to treat the sarcoidosis. Do you smoke? You have Emphysema also? The Xolair won't help the emphysema because of the damage to your lungs by whatever caused the Emphysema. But, again, controlling your asthma will make it easier to treat the emphysema. Welcome again. We are all pulling for you. Pat --------------------------------- Photos Ring in the New Year with Photo Calendars. Add photos, events, holidays, whatever. Quote Link to comment Share on other sites More sharing options...
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