Brinsupri - What Medicare Part D Supplements cover it?

@cholash This is a very appropriate question at this time of year, since this is the season for choosing plans for 2027.
I do not use Brinsupri, but I had a problem with Part D coverage for a couple meds in the past. At open season, I called each Medicare Part D provider I was considering to find out how one would go about getting coverage for the specific medications. (As a retiree, I have access to my former employer's plans for my Medicare supplement, and each had their own Part D provider options.) I had to call several places - a lot of work, but in the end, all of my medications are covered - some with relatively high co-pays, but I factored that in to my total medical costs for the year. So for the rest of this year, my Rx are all free because I hit the cap.

Now, with all the news about limitations and changes, I will repeat this exercise to include all of our prescriptions. In addition, I must look at the main plan carefully because I have arthritis and often have orthopedic surgeries, these require ongoing physical therapy. My current plan allows 50 visits per year, and I come close to requiring that many. I will read the plan carefully to be sure this isn't reduced.

@sueinmn I left a comment but for some reason it didn’t load . Hope you don’t get this twice .
Thanks for all your info . Very helpful .
I’m also a frequent offender with orthopedic surgeries , PT, etc. Thanks for bringing that to my attention when looking at plans .

If you do nor have coverage you can contact TAF (The Assistance Fund).
The people that contact me from the Pharmacy that sends me Brinsupri told me to apply for this. I did not believe I could qualify as I have a good secondary Rx insurance , but i did and I have never paid a cent for it so far.

@camilleups you have to qualify for the assistance fund . If your income is over a certain amount , you will not be eligible .

I am no longer taking Brinsupri but got it approved using AARP Medicare RX Saver from United Health Care. Had to pay the out of pocket limit which is quite alot considering I only used it for 8 weeks!

I have Humana for part D. They covered it this year although it's not formulary of course. My pulmonologist must have applied for a formulary exception, and I had to pay the part D cap the first month I was on it. Now I'm worrying about 2027, because my pulmonologist is on an extended maternity leave. I will have to apply for the formulary exception myself. I responded to my Medicare ins agent's email request to fill out the form for part D (RX list) she needs and I hope she will help me before the deadline, but the agency has already warned that they are prioritizing people who are losing Advantage Coverage in our area, so I'll be later on the list to have a meeting. I guess meanwhile I will call Humana.

TAF (The Assistance Fund) pays for my Brinsupri and I don't recall having to disclose my financial information. Maybe I have forgotten that part because this happened a year ago. I felt that my pulmonologist and Inlighten (a program for patients who are prescribed Insmed medications) arranged for TAF to get involved. It only takes a month or two for your prescription costs for the year to reach the maximum ($2,100 in 2026) so after that point you have no more copays on any of your prescriptions, which is awesome.

@ursala7 Do you have an Advantage Plan ?

@cholash No,
i have traditional Medicare with separate part D

@irenea8 that really stinks!!!