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Cost of Camzyos on Medicare Drug Plan
Hypertrophic Cardiomyopathy (HCM) | Last Active: 4 days ago | Replies (25)Comment receiving replies
My traditional Part D Medicare Rx covered 100% of my camzyos for 2024. My Part D is through UHC and I had to change pharmacies to Walgreens. On the back of my EOB summary highlighted under the Drug Payment stages states I am in the "Catastrophic Coverage : In this stage, the plan pays all the cost for your covered Part D drugs."
When I first started on Camzyos (1.5 years ago), My doctors office had to fill out a form to Medicare stating that there was no other drug available for my condition. Fortunately my cardiologist and the cardiology department is experienced with the Camzyos patient and the craziness we have to go through to get covered.
Hopkins should be experienced with this process at this point. I found this for you - it is the form Hopkins has for applying for Camzyos
https://www.hopkinsmedicine.org/-/media/johns-hopkins-health-plans/documents/usfhp/usfhp_camzyos_pa_form.pdf
Replies to "My traditional Part D Medicare Rx covered 100% of my camzyos for 2024. My Part D..."
Please, tell me more: I have UHC Medicare Advantage PPO and after lots of calculations about Camzyos, the UHC customer rep said it would be about $500 to $800 "out of pocket". This means at least $6000 out of pocket for me, which I don't have because I'm helping other family members who are struggling financially due to unemployment, displacement from climate-crisis events in FL and CA etc.
Should I google Catastrophic Coverage or would that be a waste of time?
I guess I could afford about $100 a month ($1200 a year) but not much more. I read that it takes about 20 years for an FDA approved drug to go "generic". I won't be on the planet in 20 years! Also . . .
Does Walgreens actually provide prescribed Camzyos?
What if we "middle-classer-retirees" are just above the cut-off for the patient assistance program from Bristol Myers Squibb?
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Thank you! Very helplful.