Brinsupri - What Medicare Part D Supplements cover it?

Posted by cholash @cholash, 2 days ago

For those of you on REGUlAR Medicare
with Part D ( *not an Advantage Plan ) & Brinsupri , who is your payer for Part D coverage ?
I’m starting the Medicare process and learning that Medicare does not cover Brinsupri . I’ve been on Brinsupri for over 1 year.
I understand that I’ll need to get a formulary exemption request from my pulmonologist , but it will ultimately depend on if my Part D payer will cover it or not .
I’ve called the specialty pharmacies , and they can’t tell me which companies are covering it, as it would be a conflict of interest for them .

So, back to my question . If you are successfully getting Brinsupri covered with Medicare Part D , which company are you using ?

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Profile picture for caphill @caphill

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.

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@caphill I’m really happy you were able to get help. I spoke with the EnLighten people this week, and they said there is an income cap for eligibility .

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Profile picture for cholash @cholash

@irenea8 that really stinks!!!

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@cholash
Oh well I had to try Brinsupri, of course. Sometimes I think about trying again but would probably have the same issue..

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Profile picture for cholash @cholash

@caphill I’m really happy you were able to get help. I spoke with the EnLighten people this week, and they said there is an income cap for eligibility .

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@cholash
That's good to know, and it makes me thankful that I'm living on just my social security and teachers pension.
My pulmonologist must have done the paperwork because I received notice that my Blue Medicare Rx Essentials has approved a formulary exception for Brinsupri. Now I know I must stay enrolled in this plan.

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Profile picture for irenea8 @irenea8

@cholash
Oh well I had to try Brinsupri, of course. Sometimes I think about trying again but would probably have the same issue..

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@irenea8 You have probably told us in an earlier post why you couldn't continue Brinsupri, but do you mind telling us again? Thank you.

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Profile picture for Liz @ursala7

@irenea8 You have probably told us in an earlier post why you couldn't continue Brinsupri, but do you mind telling us again? Thank you.

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@ursala7
Well me and my odd reactions to things. I developed severe vertigo (had three severe attacks). The rest of the time after the first attack I felt on the verge of vertigo all the time so it was very unpleasant. And the attacks were scary. After stopping it went away and has not come back. I will never know for sure it was from Brinsupri but my pulmo thought it probably was. Such a huge bummer.

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Profile picture for irenea8 @irenea8

@ursala7
Well me and my odd reactions to things. I developed severe vertigo (had three severe attacks). The rest of the time after the first attack I felt on the verge of vertigo all the time so it was very unpleasant. And the attacks were scary. After stopping it went away and has not come back. I will never know for sure it was from Brinsupri but my pulmo thought it probably was. Such a huge bummer.

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@irenea8 Sorry to hear that. Bummer is right. I'm sure eight weeks wasn't long enough to know if Brinsupri was making a dent in your symptoms, and even if it was, the vertigo was so distressing, it would have consumed all your attention. Add insult to injury with your out-of-pocket Part D cost. I have no idea if Brinsupri is working for me. I still cough up a lot of mucus, but I try to be hopeful.

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