1. < Digestive Health
Profile picture for janspons

Medication change - Oral meds vs. injectables

Posted by janspons @janspons, 1 day ago

I have had IBD since 1987 - UC, Jpouch & now Crohns. I have been on oral meds & OTC meds for as long as I can remember. I currently have no blood or pain, but am having leakage at night & do have some inflammation & a polyp in my pouch. My GI has prescribed Tremfya for me currently, and I can't decide if I should switch or not. Just went on Medicare & w/my drug plan, the cost is still quite high with now being on a fixed income, no grants available at present, so for next 4 months would cost me about $1800 out of pocket. Anyone have any positive/negative outcomes or advice? Thanks much.

Interested in more discussions like this? Go to the Digestive Health Support Group.

Profile picture for parrot53
parrot53 | @parrot53 | 13 hours ago

So sorry for your distress. About medication costs. Perhaps when the annual renewal for coverage comes up you can get some help with choosing a prescription coverage that will cover your specific meds better. The coverage changes each year so that affects your costs. You can use the Medicare site
https://www.medicare.gov/health-drug-plans/part-d/what-drug-plans-cover/how-drug-plans-work To help you choose. I have a secondary policy that costs me a monthly premium but covers the 20% not covered by Medicare. The agent does an annual search based on the drugs I need for the coming year and recommends the best drug plan to choose for the next year. You can do the same thing on the Medicare site once the new plans come out, I think in October/November. You put in the drugs you will need and then see the plans with the best coverage for those drugs.

REPLY
1 reply
Profile picture for janspons
janspons | @janspons | 4 hours ago
In reply to @parrot53 "So sorry for your distress. About medication costs. Perhaps when the annual renewal for coverage comes..." + (show)
Profile picture for parrot53 @parrot53

So sorry for your distress. About medication costs. Perhaps when the annual renewal for coverage comes up you can get some help with choosing a prescription coverage that will cover your specific meds better. The coverage changes each year so that affects your costs. You can use the Medicare site
https://www.medicare.gov/health-drug-plans/part-d/what-drug-plans-cover/how-drug-plans-work To help you choose. I have a secondary policy that costs me a monthly premium but covers the 20% not covered by Medicare. The agent does an annual search based on the drugs I need for the coming year and recommends the best drug plan to choose for the next year. You can do the same thing on the Medicare site once the new plans come out, I think in October/November. You put in the drugs you will need and then see the plans with the best coverage for those drugs.

Jump to this post

Thanks for the information, I do have a plan that has a $2000 cap, and I guess my cost puts me into the catastrophic category. I don't pay any premium for the part D plan that I have, but would be worth looking at a secondary policy if it was reasonable to cover the balance. I signed up for the Medicare Prescription Plan, that will break down the $2000 into affordable payments throughout the year so I don't have to pay a lump sum. I have Wellcare, and spoke with an agent at Express-Scripts that broke things down so it was easy to understand. He was very helpful and patient and answered & explained everything very well. I appreciate your input, always nice to get others views & experiences.

REPLY
Please sign in or register to post a reply.