Anyone know anything about Medicare Part D Catastrophic insurance?

[Otters27]

My mom needs a drug that cost 230,000 dollars a year. Whats the max she will have to pay out of pocket per year?

[nyplayer33]

What drug

[jjgold]

Drug companies a rip off

[Otters27]

What drug

Lorbrena by pfizer

[Sam Odom]

after $5K yr catastrophic coverage kicks in

% drops way down

'min' copay -- the exact # ... dont know

[Otters27]

Drug companies a rip off

yes its like they try to put a price on your life

[Otters27]

after $5K yr catastrophic coverage kicks in

% drops way down

'min' copay -- the exact # ... dont know

she has silver scripts supplemental as well. know anything about that

[Otters27]

What drug

looks like it is not covered by Medicare part d

[Sam Odom]

she has silver scripts supplemental as well. know anything about that

sorry , No

[slayer14]

Why medical care in USA a disaster

[pavyracer]

Maybe next time you go to Walmart to send a ** to the books stop by the pharmacy and ask the people who know about drugs instead of asking random gamblers.

[Otters27]

Maybe next time you go to Walmart to send a ** to the books stop by the pharmacy and ask the people who know about drugs instead of asking random gamblers.

lots of smart guys on here that know a lot of stuff

[pavyracer]

lots of smart guys on here that know a lot of stuff

Lots of smart guys here but you don't take any advice. You lose your bankroll every week on 25 team parlays instead of listening to the smart guys.

[san2c]

Will have to pay deductible + coverage gap. Usually $2500-3500 out of pocket. Rest of year should be covered until 12/31 when it resets.

[Otters27]

Will have to pay deductible + coverage gap. Usually $2500-3500 out of pocket. Rest of year should be covered until 12/31 when it resets.

even if the drug is not on the formulary list?

[Otters27]

Lots of smart guys here but you don't take any advice. You lose your bankroll every week on 25 team parlays instead of listening to the smart guys.

Honestly this time just trying to figure this out for my mom here.

[Sam Odom]

This information is not a complete description of benefits. Call Customer Care at Phone Number 1-866-362-6212 (TTY:Phone Number 711) 24 hours a day, 7 days a week for more information.

[Preds13]

This drug should have copay assistance from Pfizer , talk to her doc about it.

[san2c]

She wont be elligible for pfizer copay assistance if she is medicare. Doctor will need to do a prior authorization with the insurance company. No specialty oncology medications will be approved without an authorization. There are also assistance funds (PAN foundation, Gooddays) for these sort of things if she can't afford it. Usually have to be pretty low income to be elligible though. DM me if you have any other questions.

[Otters27]

She wont be elligible for pfizer copay assistance if she is medicare. Doctor will need to do a prior authorization with the insurance company. No specialty oncology medications will be approved without an authorization. There are also assistance funds (PAN foundation, Gooddays) for these sort of things if she can't afford it. Usually have to be pretty low income to be elligible though. DM me if you have any other questions.

Thanks man. I'll ship you some points if Jax State wins

[Otters27]

This information is not a complete description of benefits. Call Customer Care at Phone Number 1-866-362-6212 (TTY:Phone Number 711) 24 hours a day, 7 days a week for more information.

Thanks Sam. Big help

[19th Hole]

Big Pharma making our lives insufferable financially.

Your physician's and/or specialist's office should give you advice. If this is a medical situation common to their practice they know the path to obtain the medicine..
I've had a similar priced medication in the past and my specialist arranged the availability.

[Otters27]

Big Pharma making our lives insufferable financially.

Your physician's and/or specialist's office should give you advice. If this is a medical situation common to their practice they know the path to obtain the medicine..
I've had a similar priced medication in the past and my specialist arranged the availability.

Yep that sounds like the rout. Thank you

[gauchojake]

You should also find out which pharmacy carries this drug and see if they will help with the PA process. This is a new drug with probably very limited availability in rural areas so if it's a specialty pharmacy they will know how to get these drugs approved. A good buddy of mine is on a very specific biologic for lung cancer and he had to go through the same thing.