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Is Camzyos effective long term?

Hypertrophic Cardiomyopathy (HCM) | Last Active: Oct 22 5:45pm | Replies (41)

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@manuelpo

Hi everyone,

I am 64 years old and I live in the State of Colorado. I still do NOT qualify for Medicare till I am going to be 65 years old next year 2025. I purchased this private insurance that covers almost all cost of Camzyos ($8,436 per month covered) the other $200 copay, Bristol Myers Squibb Laboratory covers $190 and my copay is only $10 per month (I had to fill out a form my nurse gave me for that. My nurse that works with my Cardiologist is a certified Camzyos nurse and my Cardiologist is a Certified Camzyos Cardiologist specialized in obstructive HCOM so they know very well all the paperwork to cover my Camzyos). After I filled out that paperwork, my nurse submitted it to Bristol Myers Squibb (BMS) who approved it based on my low income (less than $50k per year for me and my wife, BMS approved it); therefore, I only pay $10 copay per month since the other $190 monthly copay is paid by BMS lab that manufactures Camzyos. Even if your income is too high, you can fill out an appeal form explaining your personal situation of other significant expenses that makes you not to afford to pay Camzyos and you will be surprised that you "may" get help from BMS.

I was too lucky to choose the Health Insurance plan I have since my Insurance broker helped me to find it out (I pay $626 per month for my Health Insurance and the other $625 per month is paid by the State of Colorado (https://connectforhealthco.com/get-started/new-customers/). My insurance is this:

UnitedHealthCare
Colorado Doctors Plan COLORADO OPTION GOLD. Rocky Mountain Health Plans.
Group ID: COONEX.
https://member.uhc.com/ifp/prelogin?deeplink=exchange&locale=en-US (copy and paste this weblink so you can search for their phone number to see what plan covers Camzyos. The one listed here above does cover me with my Camzyos 5 mg)
My deductible is $1,700 individual and $3,000.
After deductible my copay is 30% in network. In Hospital cover Ded + 30%. Doctor visits Primary Care no copay and Urgent Care copay $50.
OUT OF NETWORK THERE IS NO COVERAGE AT ALL NO MATTER WHAT.
For the new enrollment period that is coming those deductibles and prices may have increased.

Since most are having problems with Medicare to cover Camzyos then, I will have to keep my insurance above since the monthly premium I pay is a lot cheaper than the monthly Camzyos cost of $8,636).

Here is the web link for my plan that you can check coverage of Camzyos. Once you copy and paste this link:
https://shop.uhcexchange.com/marketplace/plan/97879CO0420013?_agent_id=uhc&apply_for_subsidy=true&call=1-877-649-9797&cid=public_relations:ifp-acquisition:ce724567&fip_code=08041&state=CO&zip_code=80924&dependents_count=0&household_size=2&is_default_scenario=false&utilization=high&custom_usage%5Busage%5D=custom&custom_usage%5Bdoctor_visits%5D=0&custom_usage%5Ber_visits%5D=0&custom_usage%5Bhospital_visits%5D=0&custom_usage%5Blabs%5D=0&custom_usage%5Bprescriptions%5D=0&custom_usage%5Bspecialist_visits%5D=0&off_ex=false&year=2024&subsidy=461.00&sort=premium_asc&hsa=false&easy_pricing=false&page=1&per_page=10&all_benefits=false&add_attributes=false&shopping_scenario=finding_plan&health_subsidy_used=0&dental_search=false&v2=true&is_hra_flow=false&dental_params%5Bbenefit_maximum%5D=&dental_params%5Bpremium%5D=&dental_params%5Bdeductible%5D=&dental_params%5Bpage%5D=1&dental_params%5Bper_page%5D=10&health_params%5Bissuer_hios_ids%5D%5B%5D=97879&health_params%5Bsort%5D=premium_asc&health_params%5Bbenefit_maximum%5D=&health_params%5Bpremium%5D=&health_params%5Bdeductible%5D=&health_params%5Bhsa%5D=false&health_params%5Beasy_pricing%5D=false&health_params%5Bpage%5D=1&health_params%5Bper_page%5D=10&show_dental=false&applicants%5B%5D%5Bage%5D=64&applicants%5B%5D%5Bage_format%5D=years&applicants%5B%5D%5Brelationship%5D=primary&applicants%5B%5D%5Bgender%5D=male&applicants%5B%5D%5Butilization%5D=medium&household_income=78000&non_applicants_under19=false&fpl_ratio=3.82&prior_year_fpl_ratio=3.96&csr_type=none&issuer_hios_ids%5B%5D=97879&sep_reason=other&benefit_maximum=&premium=&deductible=&backPath=/marketplace/health#
then click on the lower part "Drug Formulary"

which takes you here (where you enter Camzyos on the search by drug name):
https://welcome.optumrx.com/rxexternal/external-prescription-drug-list?type=ClientFormulary&var=GPX524CO&infoid=GPX524CO&page=insert&par=
which will show you coverage 1 pill per day for 30 day supply. Then your doctor can refill sending prescription so you can get it every month.

Notice the weblink above is based on my income that was low last year so your monthly premium depends on your gross taxable income.

I hope this information helps and I wish the best to everyone.
God bless all of you and I hope all of you improve your health.

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Replies to "Hi everyone, I am 64 years old and I live in the State of Colorado. I..."

Thank you for all that information. I will be calling the Bristol Myers Squibb Nurse Navigator tomorrow morning. Hope they will be able to assist me with a drug plan and considerations. What makes it so much more confusing is that the plans vary by location. I am in Indiana. I will also be calling a Medicare advisor. All this is enough to give me more rapid heartbeat, chest pain and shortness of breath!