lilMeggies
New member
This is for whose of you in the US.....do you guys pay for your enzymes and other treatments....what is covered for you guys?
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treatment Costs
- Thread starter lilMeggies
- Start date
lilMeggies
New member
This is for whose of you in the US.....do you guys pay for your enzymes and other treatments....what is covered for you guys?
Right now, Medicare pays for my TOBI nebs and soon my Pulmozyme once it is ordered. Which is great considering they both cost a fortune. My IV's..that's another story...usually I stay in the hospitial for my treatments, but soon Medicare will cover the drugs that I use at home....took forever to find a plan that would do that, but that would be great to be home on IV's instead of the hospital. My enzymes I was paying some out of pocket, not sure how much of it will be covered now that this new prescription plan came out with the Medicare. Medicare also pays for my vent, its supplies, and my Vest
Some people have private insurance, some have state assistance (believe it or not, I make too much to qualify for Medicaid- a state funded medical insurance, with my disability), also there are programs out there to help CF folks.
Some people have private insurance, some have state assistance (believe it or not, I make too much to qualify for Medicaid- a state funded medical insurance, with my disability), also there are programs out there to help CF folks.
Right now, Medicare pays for my TOBI nebs and soon my Pulmozyme once it is ordered. Which is great considering they both cost a fortune. My IV's..that's another story...usually I stay in the hospitial for my treatments, but soon Medicare will cover the drugs that I use at home....took forever to find a plan that would do that, but that would be great to be home on IV's instead of the hospital. My enzymes I was paying some out of pocket, not sure how much of it will be covered now that this new prescription plan came out with the Medicare. Medicare also pays for my vent, its supplies, and my Vest
Some people have private insurance, some have state assistance (believe it or not, I make too much to qualify for Medicaid- a state funded medical insurance, with my disability), also there are programs out there to help CF folks.
Some people have private insurance, some have state assistance (believe it or not, I make too much to qualify for Medicaid- a state funded medical insurance, with my disability), also there are programs out there to help CF folks.
It all depends on what insurance you have. Luckily mine is pretty good, they cover 100% of almost everything, my deductable is only $200 per year, and perscriptions only cost $7 no matter what it is (if I go to the online pharmacy its $14 for 3 months worth of meds). Unfortunately too many people have insurance that isn't nearly as good.
It all depends on what insurance you have. Luckily mine is pretty good, they cover 100% of almost everything, my deductable is only $200 per year, and perscriptions only cost $7 no matter what it is (if I go to the online pharmacy its $14 for 3 months worth of meds). Unfortunately too many people have insurance that isn't nearly as good.
lilMeggies
New member
and if you can't afford your meds....what happens?
lilMeggies
New member
and if you can't afford your meds....what happens?
- you go without. Sad as it is, that is the case. Being a cfer in the US, you really have to be ready to fight for your coverage if you can't get it through work, or are unable to work. Some states work insurance will deny you for pre-exisiting conditions - mine did, so I moved to another state with better healthcare coverage (employer and state).
- you go without. Sad as it is, that is the case. Being a cfer in the US, you really have to be ready to fight for your coverage if you can't get it through work, or are unable to work. Some states work insurance will deny you for pre-exisiting conditions - mine did, so I moved to another state with better healthcare coverage (employer and state).
If you can't afford your meds you pretty much are out of luck. The tobi foundation does have a scholarship program where they will provide for free or at a very limited cost the medications, I believe pulmozyme has something similar. Not too sure about the enzyme companies though.
It's a times like this that I dont' mind that my insurance is billed $2500 a month for Mark's TOBI, so that the foundation can afford to give it to others a limited or no cost.
My insurance won't cover any nutritional supplements, which is part of what helps keep Mark's weight up, keep his health up, keep his lung infections away.... In CA medicaid paid for them for about 3 months. In WA Mark doesn't qualify for medicaid anymore (big confusing deal, still working on it) so we pay $450.00 a month out of pocket for the Ensure's every month.
Sometimes you have to rearrange your budget, cut out things you thought you need but really can live without.. ask for help. but we don't have a healthcare system set up like yours at all.
It's a times like this that I dont' mind that my insurance is billed $2500 a month for Mark's TOBI, so that the foundation can afford to give it to others a limited or no cost.
My insurance won't cover any nutritional supplements, which is part of what helps keep Mark's weight up, keep his health up, keep his lung infections away.... In CA medicaid paid for them for about 3 months. In WA Mark doesn't qualify for medicaid anymore (big confusing deal, still working on it) so we pay $450.00 a month out of pocket for the Ensure's every month.
Sometimes you have to rearrange your budget, cut out things you thought you need but really can live without.. ask for help. but we don't have a healthcare system set up like yours at all.
If you can't afford your meds you pretty much are out of luck. The tobi foundation does have a scholarship program where they will provide for free or at a very limited cost the medications, I believe pulmozyme has something similar. Not too sure about the enzyme companies though.
It's a times like this that I dont' mind that my insurance is billed $2500 a month for Mark's TOBI, so that the foundation can afford to give it to others a limited or no cost.
My insurance won't cover any nutritional supplements, which is part of what helps keep Mark's weight up, keep his health up, keep his lung infections away.... In CA medicaid paid for them for about 3 months. In WA Mark doesn't qualify for medicaid anymore (big confusing deal, still working on it) so we pay $450.00 a month out of pocket for the Ensure's every month.
Sometimes you have to rearrange your budget, cut out things you thought you need but really can live without.. ask for help. but we don't have a healthcare system set up like yours at all.
It's a times like this that I dont' mind that my insurance is billed $2500 a month for Mark's TOBI, so that the foundation can afford to give it to others a limited or no cost.
My insurance won't cover any nutritional supplements, which is part of what helps keep Mark's weight up, keep his health up, keep his lung infections away.... In CA medicaid paid for them for about 3 months. In WA Mark doesn't qualify for medicaid anymore (big confusing deal, still working on it) so we pay $450.00 a month out of pocket for the Ensure's every month.
Sometimes you have to rearrange your budget, cut out things you thought you need but really can live without.. ask for help. but we don't have a healthcare system set up like yours at all.
There's a program here in Tennessee (it might be in other states, I don't know) called Children's Special Services. It's designed to help families get meds for their children until they're 18, but they make an exception for people w/ CF, covering them for life, as long as they don't exceed a certain income. For me, a single 25 year old male, the number is $1,200 a month. This is fine for me right now, b/c I'm currently a full time college student, living at home and working part-time. After I graduate and get a real job, I just hope I get some good insurance!
There's a program here in Tennessee (it might be in other states, I don't know) called Children's Special Services. It's designed to help families get meds for their children until they're 18, but they make an exception for people w/ CF, covering them for life, as long as they don't exceed a certain income. For me, a single 25 year old male, the number is $1,200 a month. This is fine for me right now, b/c I'm currently a full time college student, living at home and working part-time. After I graduate and get a real job, I just hope I get some good insurance!
In our local paper there was an article that talked how some of the Charity Programs available thru manufacturers are being changed. The guidelines are being changed now that Medicare Part D is available. I dont know how it will affect the CF Programs, but the gentleman that the story was based around was a severe asmthatic with diabetes & high blood pressure. The meds he will no longer get thru the charity programs were Advair & Pulmicort. He is like many people without prescription drug coverage. Not really making enough with Social Security to swing the Part D plan yet no longer eligible for charity care or state assistance! Thought I would mention this to anyone in case it does affect us CFers. Mind U this only affects those eligible for Medicare!
In our local paper there was an article that talked how some of the Charity Programs available thru manufacturers are being changed. The guidelines are being changed now that Medicare Part D is available. I dont know how it will affect the CF Programs, but the gentleman that the story was based around was a severe asmthatic with diabetes & high blood pressure. The meds he will no longer get thru the charity programs were Advair & Pulmicort. He is like many people without prescription drug coverage. Not really making enough with Social Security to swing the Part D plan yet no longer eligible for charity care or state assistance! Thought I would mention this to anyone in case it does affect us CFers. Mind U this only affects those eligible for Medicare!
I am on the program w/pulmozyme and TOBI- I have called the US company that redistributes my enzymes (Ultrase) the only programs they have are; they will give me some of their multivitamins at a lower cost, and ooh a voucher for SOME shakes. I put out 250.00 a month for enzymes. The co. said they do not have a program, but are working on it, but don't loose any sleep over it. There used to be certain states that had programs (in AZ is used to be called childrens rehabilitative services), and covered CF through adulthood. But with all the changes in insurance companies I am told these states will redesign their programs and possibly terminate them.
I am on the program w/pulmozyme and TOBI- I have called the US company that redistributes my enzymes (Ultrase) the only programs they have are; they will give me some of their multivitamins at a lower cost, and ooh a voucher for SOME shakes. I put out 250.00 a month for enzymes. The co. said they do not have a program, but are working on it, but don't loose any sleep over it. There used to be certain states that had programs (in AZ is used to be called childrens rehabilitative services), and covered CF through adulthood. But with all the changes in insurance companies I am told these states will redesign their programs and possibly terminate them.