Medicare - Can't afford medication

[Anonymous]

My mom has been dealing with an awful medical issue for the last 8-9 years that have had doctors completely stumped. After many years and several visits to different specialists, although there's still no diagnosis they have finally found a family of medications that quiets the issue and makes her daily life manageable. The problem is that the medication is $6K a month, which of course she cannot afford. Most people cannot. She is far from destitute, but also not in the financial position to spend this kind of money. Basically she has too much in assets and income from retirement to qualify for the low-income benefits from the pharma company. She has tried every medication in this family and each of them works, and each of them is just unaffordable. Has anyone run into this kind of issue? I feel like there is just no way around it because she's on medicare and "too wealthy", but wanted to get input from others.

PS she has asked for samples from her doctors. They've obliged but have only given her a one month supply, that's it.

Thanks

[Anonymous]

Have her doctors contact the manufacturer to see if they have a compassionate use program.

[Anonymous]

Anonymous wrote:Have her doctors contact the manufacturer to see if they have a compassionate use program.

Wouldn't something like that income/asset based?

[Anonymous]

Anonymous wrote:Have her doctors contact the manufacturer to see if they have a compassionate use program.

There is an age limit on this of 63. My mom is 82.

[Anonymous]

Tough one. Write to your congressman?

[Anonymous]

Check with the drug manufacturer. Sometimes they have a discount program for a period time time, regardless of income. My XH was on hormone replacement due to pituitary issues and had one of his expensive meds subsidized heavily by the manufacturer.

[Anonymous]

AllDay Chemist. India. Shipment takes about 30 days.
Medication costs almost nothing compared to what we pay in the US. Most of our meds are manufactured in India.

[Anonymous]

Call Medicare on the back of her card and they will look at the prescriptions and help you choose a better plan. Also, get her a supplement.

[Anonymous]

Anonymous wrote:Check with the drug manufacturer. Sometimes they have a discount program for a period time time, regardless of income. My XH was on hormone replacement due to pituitary issues and had one of his expensive meds subsidized heavily by the manufacturer.

She did talk to the pharma company directly, the discount program is only for those who qualify as low income. She also spoke to her doctor who basically was on no help - I don't think it's out of not wanting to help rather due to lack of time and resources.

[Anonymous]

Anonymous wrote:AllDay Chemist. India. Shipment takes about 30 days.
Medication costs almost nothing compared to what we pay in the US. Most of our meds are manufactured in India.

I just checked, this family of medications is not available on their website.

[Anonymous]

Anonymous wrote:Call Medicare on the back of her card and they will look at the prescriptions and help you choose a better plan. Also, get her a supplement.

She has Part D supplement. She pays $104 a month for that, and takes no other medications. So basically she's paying for nothing at this point. In terms of getting a better plan, we've already discussed this - she would have to wait until the end of the year, and even then she's not sure if there is a plan that will solve this issue.

[Anonymous]

What's the medication?

[Anonymous]

Have you looked if the medications are available via the 340B program?

[Anonymous]

Anonymous wrote:What's the medication?

I believe that's for Medicaid patients, my mom is on Medicare

[Anonymous]

Anonymous wrote:

Anonymous wrote:Check with the drug manufacturer. Sometimes they have a discount program for a period time time, regardless of income. My XH was on hormone replacement due to pituitary issues and had one of his expensive meds subsidized heavily by the manufacturer.

She did talk to the pharma company directly, the discount program is only for those who qualify as low income. She also spoke to her doctor who basically was on no help - I don't think it's out of not wanting to help rather due to lack of time and resources.

I looked into this issue for a friend a while ago. The rules on discounting medication are complicated, and I don't completely understand all the issues, but basically - keep trying.

There are coupons from the drug company to make drugs affordable, but the law says you can't use these coupons, if you are a Medicare recipient. But, it might be that you can choose to buy the drug yourself without asking Medicare to cover it.

https://www.medicalnewstoday.com/articles/drug-coupons-and-medicare

I think legally the company isn't supposed to tell you about ways to afford the medication if you are on Medicare. But there may be ways around it - keep looking. Google the name of the medication and "Medicare solutions" etc.