This Is MS Multiple Sclerosis Community: Knowledge & Support

Kareng7,
I too am on the high side, ($386) thru Direct Delivery. I am on a BC/BS plan.

I'd love to hear which insurance company JDamon has! I don't think I qualify for anything less (not a Veteran etc.). Anybody on BC/BS with low cost for Avonex???????

I think our plan goes through Wellpoint pharmacy for the mail-order prescriptions and they charge $60 for a 3 month suppy. If it was filled at a local pharmacy the price would be $30 per month. All the medical stuff goes through Blue Cross.

Not as good as at my previous company though, where there was no copay for injectibles like Avonex so it was free.

I am a retired military spouse and I get a 3 months supply of Avonex for a 9$ co-pay. Our insurance company is Tricare Prime.

My husband was in the Army over 30 years so I think we served our time!

$0

I have just found this Avonex forum..sorry for the late reply. Also very curious as to how others absorb the costs of these drugs!
I guess I am a "lucky" one- since it is injectable, it is covered under my medical expenses instead of prescription. I still have to fork out over 10% of my net pay every month just for the Avonex, but then I finally reach my out of pocket limit and they pay at 100%. I am employed and my insurance is offered through my empoyer. It is a great plan for me because all the doctors I see are preferred providers which means they cover a higher percentage of the costs. I also insure my huband, as he is self-employed and his insurance before we married was very expensive.
BTW, at the beginnig the insurance company was being very weird about covering the Avonex- one day they were going to cover it, the next day not..so I called them up and when I got a real person on the phone I informed them than I was going to record this call for quality purposes.
(anyone who has been on the phone with any business knows to what I am referring!) The change in their attitude was amazing- I got complete answers in a respectful way, and best of all they followed through with everything they stated in that conversation. No more run around! Yeah!
Sneaky? Naw, more like CYA.
Oh yeah, when I was first going to start on the Avonex, Biogen Active Source were the ones who found the pharmacy, set up a delivery, and contacted my insurer initially to verify the best way to get the most coverage. Most helpful!
Hope this can help someone.

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Beck

After my $1500 deductable, my insurance pays for everything 100% (up to 5million) It's a blessing, and if I ever lose this insurance (which they TRY to drop me every month) then I'm in trouble. But for now, it's the best deal goin! Pre-filled at Brooks Pharmacy is $3111.95 and through mail order I have it for $1583. (so I pay for less than a month of it before it comes for free) It's through First Health insurance...

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"Some women aren't meant to be tamed... we are meant to run free until we find someone just as wild to run with"

ClancyP-
Our company is self-insured, they just use a benefits administrator.
Wow, I don't bring home $1500 a month, how do you absorb that expense? I guess you know it's coming and you can save up for it?
Why do you say that your insurance company keeps trying to drop you?
What are they doing that makes you say that?
We would definitely be in trouble if I lost my job...

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Beck

Oh... maybe I was unclear Each year I pay $1500 ONE TIME... then they pay for everything. I just absorb it as part of my insurance plan (I pay about $3000 a year and am thankful) We don't have a problem saving for that one time deductable because... well... we know that the drugs alone cost more than that much each month without insurance!

My insurance company is a complete nightmare. They figure out a new way every quarter to try to tell me that my account is in trouble: when I got married, they claimed they couldn't cash my check to pay for my plan because it had a different name on it than usual. (though I had sent them copies of my marraige cert. and new ID) It's just little stuff each month... like one month my check had about a quarter of an inch torn out of the edge and they said that it was invalid and that I was now delinquint on my payments. BOGUS!!! I'm the most on-top-of-things gal you'll ever meet, so they never have a leg to stand on. But it's still a total frustration.

That is another rant I will get into another time... it's boring and confusing and I don't want to gank this person's thread any more than I already have

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"Some women aren't meant to be tamed... we are meant to run free until we find someone just as wild to run with"

My out of pocket on meds for the year is $1000. When I order my first 3 months of Avonex for the year that balance is met. I put $500 of that balance on a credit card the rest I have them bill me for. I then fill out a form at my employer's benefits office for medication assistance. My employer gives me $500 dollars of assistance once I have paid $500 on medications. I pay off the balance on my credit card with the financial assitance and only have to pay the remaining $500 dollars over the rest of year which works out to around $42 a month.

When I read most of the replies I feel like my insurance is even worse that it seemed before I started reading. I am self-insured and due to the deductible I paid $800 for the first month. Every month after is $500 until the end of the year at which point it's back to meeting the deductible and coming up with another $800. I am still in shock about the price. Between the cost and increasing discomfort with the shot, I am condering going off it.

Copaxone has been around since the mid 90's and the price just continues to go up. Normally it's the other way around by the companies who manufacture the approved MS drugs are the only game in town and charge what the market will pay!

If these drugs gave a much higher efficacy on the disease it would likely be worth but unfortunately they don't. If one's insurance doesn't pay the shot, then it becomes a difficult decision on whether to continue or not.

Harry

It is so sad that in addition to having MS, people are being financially ripped off by drugs that offer questionable benefits.

I have to say we in Australia are very lucky. All the CRABS are subsidised by the federal government (maximum cost is $30 per month), and depending on the neurologist you see, it can even be free. My wife goes to one of the leading MS specialists in Australia - and doesn't pay a cent. Nothing for consultations, nothing for MRIs, nothing for IV steroids when required... It's not as if she is a special case or because we have additional insurance - the neuro works out of a specialist MS clinic in a public hospital.

Of course, if you're very wealthy, then the US offers additional benefits (such slightly quicker access to newer drugs), but given the risks with new drugs, that is not always such a good thing I guess.

Walmart price for one month supply of Avonex is:

$2,941.00



I thought they were going to beat everyone eles prices!?

Hi...in Australia Avonex is $1000AUD per month and I pay $30 for a month's supply. The govt Pharmaceuticals Benefits Scheme pays the rest. Whoops, sorry didnt see that there was already a post about Australian Avonex costs.