I Hate Dialysis Message Board

Dialysis Discussion => Dialysis: Transplant Discussion => Topic started by: BASSMAN on October 25, 2010, 04:18:49 PM

Title: Let The Goat Rope Begin!!!!
Post by: BASSMAN on October 25, 2010, 04:18:49 PM

 :banghead; :banghead;

Medicare denied my claim I filed on my immuno-suppressant drugs.  The reason (service not covered).  JESUS!!!!!
Ignorance abounds!

I have prescription drug insurance through my employer, however I still fork out about 225.00 a month out of my pocket.  It was my understanding that Medicare, being secondary payer, would partially reimburse some of my copay.

So now I have to file an appeal.

Has anyone had any similar experience???  How did it come out???

I can afford the 225.00 out of pocket per month but it is a chunk of change out of my budget. 

Title: Re: Let The Goat Rope Begin!!!!
Post by: paris on October 25, 2010, 04:33:01 PM

What?  I am in the beginning stages of this drug thing.  I was really hoping they would cover the big drugs.  Well, so far we can cover the co-pays, but after awhile, we may have to choose between meds or food!    This whole Medicare things isn't going to be easy, is it?

Title: Re: Let The Goat Rope Begin!!!!
Post by: Rerun on October 25, 2010, 07:49:00 PM

Keep us posted.  When I had my transplant 25 years ago there wasn't the ruling for the 3 year pay out but my understanding is that Medicare paid for 3 years of transplant drugs.

CALL them.

Title: Re: Let The Goat Rope Begin!!!!
Post by: jbeany on October 25, 2010, 08:54:24 PM

They are billing it wrong - it needs to be billed under Part B, not Part D.  I don't pay a cent for mine.  If your hospital has a mail-order transplant pharmacy, sign up - it saves a whooooole lot of hassle to work with people who do nothing but transplant meds every day.