There are probably several different factors (some of which have been mentioned already) that could contribute to the variance in charges, but my concerns would be:

- the lifetime cap for treatment coverage (mine is one million, which wouldn’t take long to reach at 100K+ per year).
- the cost to the “plan”, which HAS to affect premiums for EVERYONE.
- that we (PwMS) could be pricing ourselves out of coverage (for future patients).

Once these insurance companies “catch on” the PwMS are a HUGE financial burden, I suspect they will eventually start writing in caveats to their plans that exclude PwMS, or at a minimum double/triple premiums for patients that are dx with it. I know that sounds extreme, but they do it for other categories already, so why not us?

A 400% difference is obviously not as major for an inexpensive treatment, as it is when we are dealing in the 10’s of thousands per year.

I think I understand that patients are limited in that they may have to go to a center within their plan, but I can’t see why the insurance carrier wouldn’t “agree” to an “exception” if it is going to save them up to $60K a year?

Cherie