Medicare denial for Cayston

Giggles

New member
That stinks! So those who use Medicare soley as their insurance coverage when you have meds that are submitted under Part B like Tobra, Colistin etc. Is Medicare just picking them up at 80% or do they pay 100%????


Thanks!
Jennifer 38 with CF and CFRD
 

Giggles

New member
That stinks! So those who use Medicare soley as their insurance coverage when you have meds that are submitted under Part B like Tobra, Colistin etc. Is Medicare just picking them up at 80% or do they pay 100%????


Thanks!
Jennifer 38 with CF and CFRD
 

Giggles

New member
That stinks! So those who use Medicare soley as their insurance coverage when you have meds that are submitted under Part B like Tobra, Colistin etc. Is Medicare just picking them up at 80% or do they pay 100%????


Thanks!
Jennifer 38 with CF and CFRD
 

Giggles

New member
That stinks! So those who use Medicare soley as their insurance coverage when you have meds that are submitted under Part B like Tobra, Colistin etc. Is Medicare just picking them up at 80% or do they pay 100%????


Thanks!
Jennifer 38 with CF and CFRD
 

Giggles

New member
That stinks! So those who use Medicare soley as their insurance coverage when you have meds that are submitted under Part B like Tobra, Colistin etc. Is Medicare just picking them up at 80% or do they pay 100%????
<br />
<br />
<br /> Thanks!
<br />Jennifer 38 with CF and CFRD
 

JustDucky

New member
Medicare part B picks up only 80%, if you have supplemental insurance (like I do) then they pick up the remaining 20% which is a godsend. Oh, and Colistin isn't covered under part B, I have part D insurance that pays for that with a $6 a month co-pay. Trust me, I shopped around before settling on a part D insurance that would cover at least generics through the infamous doughnut hole. Colistin fortunately does come in generic and is covered....my part D insurance pays 1300 a month for that stuff, I am so glad for that coverage!
Yes, it sucks sideways that those who are on medicare and who can't afford to pay for CAyston miss out on a potentially great treatment until insurance changes. I think that CAyston will eventually be covered as it is a CF specific drug, like TOBI (I know docs use it in other patient populations, such as those with idopathic bronchiectasis, but it is the CF diagnosis is why medicare is picking it up with me) . Fingers crossed as my options are quickly running out as far as treating my bugs go.
Hope this helps...
Jenn
 

JustDucky

New member
Medicare part B picks up only 80%, if you have supplemental insurance (like I do) then they pick up the remaining 20% which is a godsend. Oh, and Colistin isn't covered under part B, I have part D insurance that pays for that with a $6 a month co-pay. Trust me, I shopped around before settling on a part D insurance that would cover at least generics through the infamous doughnut hole. Colistin fortunately does come in generic and is covered....my part D insurance pays 1300 a month for that stuff, I am so glad for that coverage!
Yes, it sucks sideways that those who are on medicare and who can't afford to pay for CAyston miss out on a potentially great treatment until insurance changes. I think that CAyston will eventually be covered as it is a CF specific drug, like TOBI (I know docs use it in other patient populations, such as those with idopathic bronchiectasis, but it is the CF diagnosis is why medicare is picking it up with me) . Fingers crossed as my options are quickly running out as far as treating my bugs go.
Hope this helps...
Jenn
 

JustDucky

New member
Medicare part B picks up only 80%, if you have supplemental insurance (like I do) then they pick up the remaining 20% which is a godsend. Oh, and Colistin isn't covered under part B, I have part D insurance that pays for that with a $6 a month co-pay. Trust me, I shopped around before settling on a part D insurance that would cover at least generics through the infamous doughnut hole. Colistin fortunately does come in generic and is covered....my part D insurance pays 1300 a month for that stuff, I am so glad for that coverage!
Yes, it sucks sideways that those who are on medicare and who can't afford to pay for CAyston miss out on a potentially great treatment until insurance changes. I think that CAyston will eventually be covered as it is a CF specific drug, like TOBI (I know docs use it in other patient populations, such as those with idopathic bronchiectasis, but it is the CF diagnosis is why medicare is picking it up with me) . Fingers crossed as my options are quickly running out as far as treating my bugs go.
Hope this helps...
Jenn
 

JustDucky

New member
Medicare part B picks up only 80%, if you have supplemental insurance (like I do) then they pick up the remaining 20% which is a godsend. Oh, and Colistin isn't covered under part B, I have part D insurance that pays for that with a $6 a month co-pay. Trust me, I shopped around before settling on a part D insurance that would cover at least generics through the infamous doughnut hole. Colistin fortunately does come in generic and is covered....my part D insurance pays 1300 a month for that stuff, I am so glad for that coverage!
Yes, it sucks sideways that those who are on medicare and who can't afford to pay for CAyston miss out on a potentially great treatment until insurance changes. I think that CAyston will eventually be covered as it is a CF specific drug, like TOBI (I know docs use it in other patient populations, such as those with idopathic bronchiectasis, but it is the CF diagnosis is why medicare is picking it up with me) . Fingers crossed as my options are quickly running out as far as treating my bugs go.
Hope this helps...
Jenn
 

JustDucky

New member
Medicare part B picks up only 80%, if you have supplemental insurance (like I do) then they pick up the remaining 20% which is a godsend. Oh, and Colistin isn't covered under part B, I have part D insurance that pays for that with a $6 a month co-pay. Trust me, I shopped around before settling on a part D insurance that would cover at least generics through the infamous doughnut hole. Colistin fortunately does come in generic and is covered....my part D insurance pays 1300 a month for that stuff, I am so glad for that coverage!
<br />Yes, it sucks sideways that those who are on medicare and who can't afford to pay for CAyston miss out on a potentially great treatment until insurance changes. I think that CAyston will eventually be covered as it is a CF specific drug, like TOBI (I know docs use it in other patient populations, such as those with idopathic bronchiectasis, but it is the CF diagnosis is why medicare is picking it up with me) . Fingers crossed as my options are quickly running out as far as treating my bugs go.
<br />Hope this helps...
<br />Jenn
 

Landy

New member
That's too bad that Medicare won't cover Cayston.<img src="i/expressions/face-icon-small-frown.gif" border="0">

My question is, where do you start with lobbying for Medicare to cover certain meds? They don't cover Xopenex either (with a CF diagnosis code). Medicare just seems so large that you don't know where to start...possibly by calling your local Representative?
 

Landy

New member
That's too bad that Medicare won't cover Cayston.<img src="i/expressions/face-icon-small-frown.gif" border="0">

My question is, where do you start with lobbying for Medicare to cover certain meds? They don't cover Xopenex either (with a CF diagnosis code). Medicare just seems so large that you don't know where to start...possibly by calling your local Representative?
 

Landy

New member
That's too bad that Medicare won't cover Cayston.<img src="i/expressions/face-icon-small-frown.gif" border="0">

My question is, where do you start with lobbying for Medicare to cover certain meds? They don't cover Xopenex either (with a CF diagnosis code). Medicare just seems so large that you don't know where to start...possibly by calling your local Representative?
 

Landy

New member
That's too bad that Medicare won't cover Cayston.<img src="i/expressions/face-icon-small-frown.gif" border="0">

My question is, where do you start with lobbying for Medicare to cover certain meds? They don't cover Xopenex either (with a CF diagnosis code). Medicare just seems so large that you don't know where to start...possibly by calling your local Representative?
 

Landy

New member
That's too bad that Medicare won't cover Cayston.<img src="i/expressions/face-icon-small-frown.gif" border="0">
<br />
<br />My question is, where do you start with lobbying for Medicare to cover certain meds? They don't cover Xopenex either (with a CF diagnosis code). Medicare just seems so large that you don't know where to start...possibly by calling your local Representative?
 

bkc3

New member
good question. I saw a link on the cff web site about becomming an advocate. You may also check with the manufacturer as well. They may be able to provide some direction. It would definitely be in their best interest for the drug to be covered. Post any info you find. I'd be happy to write a letter to try to help if you find out where to send them.
 

bkc3

New member
good question. I saw a link on the cff web site about becomming an advocate. You may also check with the manufacturer as well. They may be able to provide some direction. It would definitely be in their best interest for the drug to be covered. Post any info you find. I'd be happy to write a letter to try to help if you find out where to send them.
 

bkc3

New member
good question. I saw a link on the cff web site about becomming an advocate. You may also check with the manufacturer as well. They may be able to provide some direction. It would definitely be in their best interest for the drug to be covered. Post any info you find. I'd be happy to write a letter to try to help if you find out where to send them.
 

bkc3

New member
good question. I saw a link on the cff web site about becomming an advocate. You may also check with the manufacturer as well. They may be able to provide some direction. It would definitely be in their best interest for the drug to be covered. Post any info you find. I'd be happy to write a letter to try to help if you find out where to send them.
 

bkc3

New member
good question. I saw a link on the cff web site about becomming an advocate. You may also check with the manufacturer as well. They may be able to provide some direction. It would definitely be in their best interest for the drug to be covered. Post any info you find. I'd be happy to write a letter to try to help if you find out where to send them.
 
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