Started Nucala

Just learned that Nucala is billed to Medicare B (yes, that is B as in Bravo) and then whatever secondary insurance you may have. I had thought since it appears to me to be a medication it would be Medicare D and/or whatever private drug coverage the patient had. Nope, after 2.75 days of getting the runaround from Nucala/GSK as well as my insurer and CVS Specialty pharmacy, I finally learned at the end of it that NO, just because it is something that is administered by syringe or auto-inject pen at home, it is NOT considered a drug and is medical care covered under Medicare B (hey why do rules have to make sense). So now that we have had a 3-way conference call that the insurer customer service person set up between me, her and the pharmaceutical company, we will have the company re-bill Medicare correctly, who will get the bill 1st and then send the statement of benefits to insurer to process and pay their portion and I should have a grand total of $0 copay! That sure is much more palatable than the $790+ per auto-inject pen that they had billed me for!

My message is if you have problems, ask that a conference call be set up with your insurer and the Nucala folks to try to straighten out the bill. Do NOT assume you have to pay whatever high amount you are billed. Also, even though it may appear to be a medication, it is NOT covered under prescription drug plans it is Medicare B!?!?!? Oh well, that seemed like time well spent ironing all of this out, and it helps any other patient, YAY!

@hicopd I’m getting ready to take my first shot of nucala tomorrow and hopefully this helps me because I been getting out of breath even with breztri and ohtuvayre. Right now I pay $30 for the nucala. When I turn 65 I was told Medicare B pays and what ever portion Medicare doesn’t pay my secondary insurance covers, I did question couple times to make sure I knew . So how is the nucala working for you, when did you start?

@suzyq61
I’ve had Nucala injections every 4 weeks since Nov 2025. I’m taking it to reduce frequency & severity of exacerbations. It seems to help increase my resting O2 saturation rate from 93 to 95%, so that makes me happy. Not sure about other effects.

I took dupixent for about 11 months prior to Nucala. Between these meds, haven’t had any exacerbations and my spirometry was higher than previously, so that’s a plus too.

Hello,
I was hoping someone would be using Nucala. My doctor mentioned he wanted to start me on either Dupixent or Nucala for ACOS Asthma and COPD.
A little uncertain about them but…it would be great if something would help.