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Baddad 07-05-2018 11:18 AM

Medicare Part D?
 
I will be starting Medicare soon and would like to know if anyone has any suggestions or warnings for plans that cover MG treatments and medications.

Currently getting Rituxan (x2 yearly) and monthly IVIG along with Pyridostigmine and some other meds for blood pressure etc. I was previously taking Cellcept, Imuran, or Cyclosporine at different times and those may come back into play in the near future.

I have Part A and Part B currently but need to choose the others. Not sure about all the other options and there is not a lot of easy to understand information out there.

Thank you in advance.

ErinBear 07-05-2018 11:49 PM

Hi Baddad,

I have Medicare Part D. It's good to compare different plans, and try to find the one which offers you the best coverage for your prescription medications. This may change from year-to-year, as the insurance companies can change their formularies, so it is worthwhile to take some time in November to review your plan again. I think Medicare has an online tool that helps you compare plans if you type in your zip code. Then you can enter the medications you take on a regular basis, and it will automatically show you different plans in your area, and their costs, if I remember right.

As far as Rituxan and IVIG are concerned, do you receive those as treatment in a hospital or outpatient treatment center? If so, those are probably paid by your regular insurance plan, and not by Medicare Part D, which generally covers medication you would get at a pharmacy and take home (like your blood pressure medications or pyridostigmine). If you get IVIG treatment through a home health care agency, it might be different. I don't know how it is billed in that case.

Best wishes,
Erin

Baddad 07-06-2018 12:43 PM

I get treated at an Infusion Center that is only about 6 miles away thankfully.

I am also looking for companies or policy types to consider or avoid. Such as would Aetna be a good company or avoid them at all cost. Personal experiences are sometimes great information.

Thank you for the help.

ErinBear 07-06-2018 07:54 PM

Dear Baddad,

If you look at the Medicare website, they will also give you an approval rating for the different insurance carriers, I think. The website is really helpful.

Have you tried asking your friends locally which carrier they use for their insurance? The carriers vary by region. What is available where I live may not be available where you live. Here, the carriers vary even by 50 miles.

It's also good to make sure that your pharmacy accepts the Part D insurance carrier you choose, if you want to stay with the same pharmacy.

Take care,
Erin

azwild 07-07-2018 12:29 AM

not sure if this helps
 
hi i get home ivig infusions its covered with my cigna medicare advantage snp plan this info may be helpful Medicare Intravenous Immune Globulin (IVIG) Demonstration | Center for Medicare & Medicaid Innovation

Baddad 07-12-2018 11:36 AM

I have read over many of the reviews but have never come across anyone that has dealt with a particular company regarding MG. Was just looking for some some first hand information with people that have MG for a comparison. No luck with Google searches either.

It is my understanding that the only way for me to receive an infusion at home would be if I were home bound or willing to pay out of pocket for the administration. My infusion center is very close, the staff is great and they are extremely helpful.

Thank you for the help


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