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Insurance coverage for Actemra infusion with straight Medicare?
Polymyalgia Rheumatica (PMR) | Last Active: 21 hours ago | Replies (25)Comment receiving replies
I am currently on Tyenne and tapering off Prednisone. I was given the choice by my Dr. to either come in once a month for an infusion or do a weekly injection myself. My copay through my insurance (not medicare) is $30.00 a month. I have had NO side effects with Tyenne and it has been working wonders for me. I wasn't able to get below 30mg of Pred without pain. I am starting my 3rd month of Tyenne and I'm down to 17.5 mg and Friday I will drop to 15mg. My Dr had me go 30,25,20,17.5 every 2 weeks. Good Luck & hope it works for you!
Replies to "I am currently on Tyenne and tapering off Prednisone. I was given the choice by my..."
Since I have straight Medicare my only choice is the infusion. With injections part D would get involved and there would be significant expense. I like the points @dadcue made about the advantages of the infusions, especially the ease of adjusting the dose if side effects show up.
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Oh one more thing, my Dr had told my that Tyenne has some kind of program that helps if people can't afford it and their insurance doesnt cover it. So if medicare doesn't cover it, check with the company that makes Tyenne.