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@annewoodmayo

Hi jgkc23,
About the expense of biologics: Please don't give up on a medication class that might improve your health because you think it is too expensive. There may be ways to pay for it. And among your medication options, there may be one that is covered.

Have you heard about these possibilities?:

Your doctor or his/her office staff should know about ways to get medications paid for. My advice is to see what biologics your doctor suggests and then let them help you see how to pay for one of them, or find some way to get someone else to pay for it for you. My doctor and her staff have been knowledgeable and helpful about paying for meds.

Medicare Part B (not the drug Part D) may pay for a biologic that you have to get in the doctor's office-- like the infused IV biologics. Part B doesn't pay for at-home shots. Maybe there is an infused IV biologic that will work for you. I think your doctor/staff should know about this option.

This is very helpful. A SHIP advisor from your state can give advice on Part D plans and which medications are on different formularies.

Sometimes the pharmaceutical companies will provide the medication for FREE or at a reduced cost.

There are philanthropic organizations that will help with the cost, too. Try doing a google search of your disease to find names of organizations, then search the site for financial support.

If you have a medicare Supplement/GAP or Advantage Plan, it might give you access to nurses who may be able to help you find resources. Hey, you've paid for the plan, so take advantage of the resource. My plan just sent me a notice that they have nurses who help find resources. I haven't tried it yet myself, but I plan to do so. On a side note, the notice didn't indicate that their nurses could actually give medical advice!

If you have already heard about these options, I'm sorry. I hope this doesn't sound too bossy. I hope these ideas have been helpful!

Good luck and I hope you feel better.

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Replies to "Hi jgkc23, About the expense of biologics: Please don't give up on a medication class that..."

Thank you so much. I did research the Medicare.gov Part B about infusions that require you to be at an infusion facility or hospital for those that take more than 31 min. I will be checking in with them this week as well as with my doctor about this. My Advantage plan will not pay for the infusion but will pay a portion of the Entyvio injections but it would cost me over $40,000/year out of pocket. No can do. Thanks so much for the info!