Will my insurance pay for Cayston?

[Jeana]

So today I went in and my FEV1 had dropped 17%. I knew I had been coughing more the last two weeks, but I didn't think it had dropped this significantly. Anyway, my staph count was very low and so it appears to be my PA that's taking over.

So, since I can't handle TOBI and I did well on Cayston during the drug study, we are starting Cayston... if my insurance company allows it. I heard Medicaid covers it right away, but I am wondering if any other insurance companies had covered it at a copay lower that 20%. I even pay only $10 a month for Pulmozyme. But I know Cayston is over 5K. What is your experience with that part of Cayston??

 

[Jeana]

So today I went in and my FEV1 had dropped 17%. I knew I had been coughing more the last two weeks, but I didn't think it had dropped this significantly. Anyway, my staph count was very low and so it appears to be my PA that's taking over.

So, since I can't handle TOBI and I did well on Cayston during the drug study, we are starting Cayston... if my insurance company allows it. I heard Medicaid covers it right away, but I am wondering if any other insurance companies had covered it at a copay lower that 20%. I even pay only $10 a month for Pulmozyme. But I know Cayston is over 5K. What is your experience with that part of Cayston??

 

[Jeana]

So today I went in and my FEV1 had dropped 17%. I knew I had been coughing more the last two weeks, but I didn't think it had dropped this significantly. Anyway, my staph count was very low and so it appears to be my PA that's taking over.
<br />
<br />So, since I can't handle TOBI and I did well on Cayston during the drug study, we are starting Cayston... if my insurance company allows it. I heard Medicaid covers it right away, but I am wondering if any other insurance companies had covered it at a copay lower that 20%. I even pay only $10 a month for Pulmozyme. But I know Cayston is over 5K. What is your experience with that part of Cayston??

 

[LouLou]

WHile most of my drugs have a flat copay for some reason Foundation Care was able to get my Cayston for me with NO COPAY! I have a PPO.

 

[LouLou]

WHile most of my drugs have a flat copay for some reason Foundation Care was able to get my Cayston for me with NO COPAY! I have a PPO.

 

[LouLou]

WHile most of my drugs have a flat copay for some reason Foundation Care was able to get my Cayston for me with NO COPAY! I have a PPO.

 

[jpetersen]

Did you call your insurance company to ask them if they cover it and at what percentage/co-pay? I should think they would have a better answer for your particular insurance than any of us not knowing what insurance you have. You can't just switch insurances because of one medication - that's not an option for CFers. I pay a $27 co-pay, but that's *my* insurance.

 

[jpetersen]

Did you call your insurance company to ask them if they cover it and at what percentage/co-pay? I should think they would have a better answer for your particular insurance than any of us not knowing what insurance you have. You can't just switch insurances because of one medication - that's not an option for CFers. I pay a $27 co-pay, but that's *my* insurance.

 

[jpetersen]

Did you call your insurance company to ask them if they cover it and at what percentage/co-pay? I should think they would have a better answer for your particular insurance than any of us not knowing what insurance you have. You can't just switch insurances because of one medication - that's not an option for CFers. I pay a $27 co-pay, but that's *my* insurance.

 

[Jeana]

They are contacting my insurance for me. Usually, specialty prescrips leave me with at most a $40 copay. Apparently, Cayston may fall out of their covered meds (for whatever reason) and then they could charge me 20%.

 

[Jeana]

They are contacting my insurance for me. Usually, specialty prescrips leave me with at most a $40 copay. Apparently, Cayston may fall out of their covered meds (for whatever reason) and then they could charge me 20%.

 

[Jeana]

They are contacting my insurance for me. Usually, specialty prescrips leave me with at most a $40 copay. Apparently, Cayston may fall out of their covered meds (for whatever reason) and then they could charge me 20%.

 

[running4life]

My doctor said I should start Cayston since I don't do my TOBI consistently because I don't have time (or don't find the time to do so). Anyway, I signed a form provided by Cayston to contact my insurance company and within a week I had everything I needed to start Cayston delivered from the CF Pharmacy for a co-pay of only $25. My insurance usually makes me pay 20% of everything but this time, Cayston paid it all. My doctor said they are doing this because it is a new drug and they want it out there on the market and people using it.

 

[running4life]

My doctor said I should start Cayston since I don't do my TOBI consistently because I don't have time (or don't find the time to do so). Anyway, I signed a form provided by Cayston to contact my insurance company and within a week I had everything I needed to start Cayston delivered from the CF Pharmacy for a co-pay of only $25. My insurance usually makes me pay 20% of everything but this time, Cayston paid it all. My doctor said they are doing this because it is a new drug and they want it out there on the market and people using it.

 

[running4life]

My doctor said I should start Cayston since I don't do my TOBI consistently because I don't have time (or don't find the time to do so). Anyway, I signed a form provided by Cayston to contact my insurance company and within a week I had everything I needed to start Cayston delivered from the CF Pharmacy for a co-pay of only $25. My insurance usually makes me pay 20% of everything but this time, Cayston paid it all. My doctor said they are doing this because it is a new drug and they want it out there on the market and people using it.

 

[Jeana]

My insurance covered 80% and for the remaining approximately $1000 a patient assistance program covered that I believe was through Cayston also (other than the $25). I hope this continues into the future, because otherwise I will not be able to afford it.

 

[Jeana]

My insurance covered 80% and for the remaining approximately $1000 a patient assistance program covered that I believe was through Cayston also (other than the $25). I hope this continues into the future, because otherwise I will not be able to afford it.

 

[Jeana]

My insurance covered 80% and for the remaining approximately $1000 a patient assistance program covered that I believe was through Cayston also (other than the $25). I hope this continues into the future, because otherwise I will not be able to afford it.

 

[triples15]

<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>Jeana</b></i>

My insurance covered 80% and for the remaining approximately $1000 a patient assistance program covered that I believe was through Cayston also (other than the $25). I hope this continues into the future, because otherwise I will not be able to afford it.</end quote></div>

Same here Jeana. Mckesson patient assistance program picked up the difference, leaving me with a $25 copay. I haven't refilled it yet, but I'm also hoping it will be the same with future fills.

Take care, I hope the Cayston helps bring your PFT's back up!

 

[triples15]

<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>Jeana</b></i>

My insurance covered 80% and for the remaining approximately $1000 a patient assistance program covered that I believe was through Cayston also (other than the $25). I hope this continues into the future, because otherwise I will not be able to afford it.</end quote>

Same here Jeana. Mckesson patient assistance program picked up the difference, leaving me with a $25 copay. I haven't refilled it yet, but I'm also hoping it will be the same with future fills.

Take care, I hope the Cayston helps bring your PFT's back up!