Calling all American transplanters! Wenchi! Donnia! Hello???

[kellyt]

Ok, my last month with Medicare is November.  After that I will only have Aetna.  I was told about a pharmacy discount card and I signed up for it and received it.  The letter that came with the card says "Start saving on Prograf and other name brand medications immediately".  Anyone have this card or know what I'm talking about?

Pharmacy Discount Card -   No approval needed.  Not insurance.  You will not be turned down for pre-existing conditions.  Provided by Health Benefits Network.

___________
UP-DATE

Ok, I just got off the phone with them and apparently you can't use it in conjunction with insurance - it's either use the discount card or the insurance (of course).   Anyway, does anyone have this card and use it over your insurance because of the savings?  Also, apparently Prograf is not on their "top 100" prescriptions, but that doesn't mean it's excluded either.   

HELP!  HOW DO YOU GUYS GET YOUR PROGRAF AND CELLCEPT ONCE YOUR MEDICARE IS GONE???  Okarol, you've sent me info before, but I can't find it!!  Do I need to schedule a meeting with my social worker from the transplant clinic?  I haven't been there in over a year.  I see my neph at his private office only.
I did receive some information from my doctor's office from the Astellas company.  I hope I qualify for their assistance.
Thanks

[kellyt]

Well, nevermind.  Apparently, you can't have private insurance for their assistance either.  Well, you can, but you have to accept generic Prograf at a discounted rate.

Well, let's just all pray that my portion or percentage of payment is not mind numbing. 

[rsudock]

Kelly sorry you are having to deal with this! Anna (Meinuk) was helping me deal with Medicare switching to primary cause they are still trying to screw me on paying their portion!!! AAggghhh!! I feel you pain...maybe this will help with PROGRAF!

I have a card called "Prograf Value Card" you CAN use it with private insurance. It is sponsored by McKesson. The number for the Prograf Value Card is 866-790-7659. Open Monday thru Friday from 8am to 8pm.  The terms and conditions are at www.mckesson.com/mprs

I know Giant Eagle will let you get Prednisone (don't know if you need that) for $4 bucks when you tell them you have NO insurance.

Hope this helps!

xo,
R

[ToddB0130]

Sorry -- I'm still pre-D,  but have a question about your post.  If it's not too peronal, why would your 'Medicare be gone' ??  I'm new to the board, maybe you posted an explanation in a different thread.    THANKS FOR ANY INFO !!!

[cattlekid]

Medicare only covers immunosupressive drugs for 36 months after transplant, unless you become eligible for Medicare due to age or other disability.  After that point, you need to make arrangements to receive your drugs through private insurance or other forms of assistance.

It is for this reason that Senator Dick Durbin from IL has sponsored a bill in the Senate that would cover immunosupressives for the life of the transplantee.  Too many people cannot afford the drugs after a transplant, then they lose the kidney and go back on dialysis, which is covered by Medicare and costs the taxpayers way more than the drugs would cost. 

Sorry -- I'm still pre-D,  but have a question about your post.  If it's not too peronal, why would your 'Medicare be gone' ??  I'm new to the board, maybe you posted an explanation in a different thread.    THANKS FOR ANY INFO !!!

[ToddB0130]

Thank you so much.  I literally learn something new at IHD every single day .........

[cariad]

Agh, Kelly, insurance issues! Beyond stressful.

Do you have prescription coverage with your insurance? If so, what sort of co-pay are they requiring? I think your best bet is to do what you've planned and go to the company for aid, and they should be able to alert you to the options that are out there. Rachel's info definitely sounds promising, too. I am hoping you find an answer that works for you soon. Stress is so damaging to health.

On a TOTALLY UNRELATED note: Medicare paid for my last bottle of Prograf, which I happened to get refilled in March, just before they told me I could stop taking it. I still have roughly 100 .5mg capsules.

[kellyt]

I do have prescription coverage and once I meet my deductible it is covered at 100%, but my deductible is 3,500/yearly, plus once I meet that I have a % that I have to cover, so basically once i pay $5000 out of pocket deductible (all medical and prescription) then meds are 100%.  I just need to deal with  it. 

Why aren't you on Prograf any longer, Cariad?

[cariad]

I do have prescription coverage and once I meet my deductible it is covered at 100%, but my deductible is 3,500/yearly, plus once I meet that I have a % that I have to cover, so basically once i pay $5000 out of pocket deductible (all medical and prescription) then meds are 100%.  I just need to deal with  it. 

Why aren't you on Prograf any longer, Cariad?

I don't take any transplant drugs anymore, ever since Gwyn gave me his stem cells along with his kidney. I've been off the lot of them since March, and my creat has yet to even reach .9

$5000 deductible is high, but I guess it depends on what your premiums are and what sort of negotiated discount just having the insurance gets you. If it comes to it, talk to your transplant center, though I would personally use this as a last, last, last resort. I think Prograf costs around $1400/month on a cash basis, so prohibitively expensive if you have to pay the entire cost upfront.

Please let us know if you find a workable solution, as I'm sure others will have this question in future.

[kellyt]

Congratulations!  I would love to be off all the antirejection meds!  Yes, $5000 is high, but we still have high premiums.  Insurance is an evil necessity for sure.

[okarol]

Not sure if this is the thread that has what you need. http://ihatedialysis.com/forum/index.php?topic=4555.0
All the patients I know who have switched to generic Prograf have no issues with it. They had labs every 3 weeks or so to be sure of the dosage, but no one I know has had adverse effects.
Our private health insurance premium is $2400 per month, plus deductibles, and has been for 10 years. It's ridiculous, but we cannot be without it.

[chris73]

cariad ...Do you take any anti rej. drugs? How do you go about stem cells being donated too? kinda curious if you dont mind....Chris

[kellyt]

Yeah, that's a good question.  I want to know, too. 

Thanks Karol.  I'm going to ask about generic again to see.  I don't mind checking labs/levels monthly or whatever.  I'll let you all know.

[okarol]

The topic is discussed on the new KidneyTalk show with Lori Hartwell.

http://ihatedialysis.com/forum/index.php?topic=24823.0

[rsudock]

Chris if you look up the post on Cariad's profile she has a post where she talks about her transplant journey. It is headed "I have a date....not the romantic kind."

She went to Northwestern for the study.

xo,
R

[sparklelady]

Kellyt,
You might try the website   needymeds.org. I found a discount card for my hubby's avodart, for my glucose strips and they can be used with private inxurance. There is also a ton of programs based on income,etc. It;s definitely worth looking into!!