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Replies to "You are correct with regards to the insurance. I started Actemra infusions 4 weeks ago. I..."
Polymyalgia Rheumatica (PMR) | Last Active: 2 days ago | Replies (30)
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You are correct with regards to the insurance. I started Actemra infusions 4 weeks ago. I just had my second infusion, yesterday. I have Medicare (not Advantage) with a supplemental plan. I chose the infusion route, since Medicare Part B would cover it after I paid my annual deductible. My Part D prescription plan would have required jumping through hoops to get it approved, with a high co-pay.
I started feeling a lot better about 2 weeks after the first infusion. More energy. I still wake up with some knee/shoulder/wrist aches, but they subside as I get moving for the day. I view Actemra has a life saver.
Replies to "You are correct with regards to the insurance. I started Actemra infusions 4 weeks ago. I..."
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It was stressful for me waiting to see if the insurance company would approve the Actemra, but I wasn't involved in any way with the process. My rheumatologist prescribed it and maybe provided justification, and after a couple of days the insurance company approved it. The reduction in the Part D cap from $8000 out of pocket max to $2000 this year helped a lot.
I never feel much difference from the Actemra injections. On the day of the injection I usually feel some really minor abdominal pains or sensations, and sometimes I feel a little tired the next day. But I know it's working since I've been able to taper the prednisone fairly rapidly with no issues.