How to get Medicare to pay for Senispar?

[katrich]

Has anyone been successful at getting Medicare to pay for Sensipar?  I have a collection of patients who are having trouble.

Kathy
FMC Social Worker

[jeannea]

Not sure what you mean. My Part D plan paid but not all. I had a $200/month copay. At least until after the donut hole.

[MommyChick]

I have a small co-pay with my Sensipar, but every couple months my Social worker has to fax a copy of my blood work for prior authorization showing i need that medication in order for them to pay most of my bill.  Otherwise my sensipar is over $800/ per mth. !
Good luck!

[Zach]

As others have written here, Medicare Part D Insurance policies usually pay for some part of the cost of Sensipar.

You can check out the formularies of the different Medicare Part D Insurance policies available in your area at:

General Information on Part D Insurance
http://www.medicare.gov/part-d/index.html

Medicare Part D Insurance Finder
https://www.medicare.gov/find-a-plan/questions/home.aspx

[geoffcamp]

I'm currently trying to afford it. I have a script I can't afford to fill, It was around $800 for 30 60mg tabs. That's almost half my entire monthly income right now. So it's shelter, food and gas OR sensipar. I watch my phosphorus and take my binders but my dietitian would really like to see me add sensipar to my already high monthly prescriptions. A couple of years ago they gave out a card for $5 for them but you have to have private insurance not Medicare part D. So I've been going without for months now. I WIIL read what is posted and if anyone does find a solution please PM me. THX. G.

[okarol]

Patient Assistance Programs | Sensipar® (cinacalcet)
See which patient assistance programs are right for you.
http://www.sensipar.com/patient-assistance-programs/index.html

Also check this out:
Safety Net Foundation for Sensipar
http://patientassistance.com/profile/amgeninc-293/

The Sensipar® Pharmacy Card Program can help insured people afford their co-pay for Sensipar®.
http://www.amgenassist.com/support_programs/sensipar_support.jsp

[thegrammalady]

i took sensipar for 5 years. my part d paid for it. my copay was only $6.25 but i get extra help because my income is so low. the regular copay would have been $35. it all depends on which part d plan you have. if your income is low and you're not getting extra help look into it. it sure helps

[The Noob]

DH medicare part D kicked in first of the year. $34 a month. no copays on any drugs, even sensipar.

that said we were out late last year and took a bit of finaggling but got the grant from PAN.
unfortunetly we had to "fibb" a little to get it. its a grant, good for a year.

[jeannea]

The problem is Part D plans have so much variation in coverage. And some areas don't have many choices for Part D. Then the discount plans don't work if you have Part D. It can be so frustrating.

[M3Riddler]

Has anyone been successful at getting Medicare to pay for Sensipar?  I have a collection of patients who are having trouble.

Kathy
FMC Social Worker

There is help out there where the Sensipar will be covered 100%. Ask your dietitian, they should have this information. I will see if I can find the exact name of the program that is helping me.    If you have a prescription drug plan, you may need to have your nephrologist fill out a pre authorization for to get it paid for to show it is medically necessary.

[geoffcamp]

THX all I'm looking into all options presented. I've gone without for about a year getting samples from time to time. My labs have been perfect but I'm told it could help and I'm game for anything that makes life better!!

Love the fact so many of you took you time to provide information for me!!   

[Cowdog]

Hi Geoff,
Just curious, with perfect labs why would they want you on Sensipar?  I took it for about two years for runaway PTH and high calcium, didn't work so I had the surgery and problem solved.

[lmunchkin]

Cowdog, it is specifically for PTH.  John took it for a few months when his was real high.  Sensipar if very expensive. Thank God his Pth dropped.  We have very little Sensipar left.  So hoping it won't go back up.  If it does, then we will cross that bridge when it arises.

lmunchkin