1. < Polymyalgia Rheumatica (PMR)
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Kevzara not being covered next year?

Posted by kpoesch @kpoesch, Nov 13 3:31pm

I've been injecting Kevzara for about 6 months. Now my Humana Medicare advantage plan is not going to cover it next year. Is anyone else dealing with this? Any suggestions?

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tweetypie13 | @tweetypie13 | Nov 17 10:27am
In reply to @kare1 "I was just perusing my Medicare plan D choices. It seems none of them cover Kezvara!!..." + (show)
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I was just perusing my Medicare plan D choices. It seems none of them cover Kezvara!! I’m in the Midwest. Not sure if locations matter but there’s no way in hell I’m paying the tens of thousands $$. Gotta hope my lowering prednisone & methotrexate work for me in 2026.

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@kare1
$$$ Kevzara has some sort of financial offer, might check it out

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kare1 | @kare1 | Nov 17 11:18am

Thanks! I see my Rheumy in a few weeks & we’ll discuss!

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ronludington | @ronludington | Nov 17 11:27am
In reply to @toryf "@kpoesch Hi there. I have been on Kevzara fro 6 months and r still on 32..." + (show)
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@kpoesch
Hi there. I have been on Kevzara fro 6 months and r still on 32 mg of Prednisone! I am not sure what your message reading 3/2 meant. I ask as I am on Kevzara and am having trouble tapering. Thank u for sharing.

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@toryf I think they meant alternating 3mg then 2 mg back to 3mg and so on.
Also , is your trouble withdrawl pain or pmr pain ? Sometimes hard to tell the difference. What hurts ?
I just took my 6th shot and reduced from 7.5 to 5 mg. But am experiencing muscle / shoulder pain. Hoping its just withdrawl.

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toryf | @toryf | Nov 17 4:29pm

Hi! Thank u for responding. I have no idea whether it's withdrawal or PMR... I had an endocrinologist tell me that until I hit 5mg of prednisone any pain I have is from the PMR. Is that not true?

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kpoesch | @kpoesch | Nov 17 8:22pm
In reply to @toryf "@kpoesch Hi there. I have been on Kevzara fro 6 months and r still on 32..." + (show)
Profile picture for toryf @toryf

@kpoesch
Hi there. I have been on Kevzara fro 6 months and r still on 32 mg of Prednisone! I am not sure what your message reading 3/2 meant. I ask as I am on Kevzara and am having trouble tapering. Thank u for sharing.

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@toryf yes I meant 3mg one day and 2 mgs. The next. Guess I'll try Methotrexate next year. I hear it can cause stomach issues for some.

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dbyrne | @dbyrne | Nov 18 7:44am
In reply to @linda7 "I'm on straight Medicare and not an Advantage Plan but I had a similar issue losing..." + (show)
Profile picture for linda7 @linda7

I'm on straight Medicare and not an Advantage Plan but I had a similar issue losing my coverage for Kevzara when the drug company's patient assistance program kicked me off at the end of last year. My part D drug plan would not cover Kevzara. You could try to get on their program called Kevzara Connect or just get some advice from them. I ended up on Actemra infusions which are covered by Medicare with a GCA diagnosis. My primary diagnosis is PMR but I have some GCA symptoms so my doctor coded it "giant cell arteritis syndrome" and the infusions are covered. Some people on this list have gotten Actemra covered for PMR so it might be worth looking into.

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@linda7

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khof | @khof | Nov 19 4:39am
In reply to @kare1 "I was just perusing my Medicare plan D choices. It seems none of them cover Kezvara!!..." + (show)
Profile picture for kare1 @kare1

I was just perusing my Medicare plan D choices. It seems none of them cover Kezvara!! I’m in the Midwest. Not sure if locations matter but there’s no way in hell I’m paying the tens of thousands $$. Gotta hope my lowering prednisone & methotrexate work for me in 2026.

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@kare1 For 2025, my medicare D did not cover Kevzara but it was covered after I met the $2000 out of pocket. Hopefully the same will be true in 2026 so I hear the out-of-pocket is $2100.

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tweetypie13 | @tweetypie13 | Nov 19 7:01am
In reply to @khof "@kare1 For 2025, my medicare D did not cover Kevzara but it was covered after I..." + (show)
Profile picture for khof @khof

@kare1 For 2025, my medicare D did not cover Kevzara but it was covered after I met the $2000 out of pocket. Hopefully the same will be true in 2026 so I hear the out-of-pocket is $2100.

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@khof
Ditto here……..

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grumpa | @grumpa | Nov 20 12:24pm
In reply to @khof "@kare1 For 2025, my medicare D did not cover Kevzara but it was covered after I..." + (show)
Profile picture for khof @khof

@kare1 For 2025, my medicare D did not cover Kevzara but it was covered after I met the $2000 out of pocket. Hopefully the same will be true in 2026 so I hear the out-of-pocket is $2100.

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@khof athats about half the cost of a 28 day supply. Two injections.

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