I’m not very knowledgeable about what meds are covered with Medicare and why you’re still required the large copay even after reaching the $8,000 level. I read over the info on the Medicare site and from everything I’m seeing, you shouldn’t have to pay out of pocket. Though it does stipulate, ‘covered drug’. I couldn’t find the list of covered drugs to see if Rituxan qualifies.
I had Rituxan infusions (almost 6 years ago) while on Medicare (Advantage plan). The infusions started in January. So basically, I was beginning the medical year having to reach the deductible. But looking back on my medical bills, the Rituxan was covered and I didn’t have a copay. Again, that was 6 years ago so I don’t know how much coverage has changed since then.
This is so frustrating for you and I’m sorry you’re having to fight for your medication! Hopefully someone with more Medicare experience will be able to pop into the conversation and give you some pointers.