If you're eligible, ,The Assistance Fund might be able to help... https://tafcares.org/patients/eligibility/
Last year, I applied too late to avoid an initial US$1000 copay. Thru TAF, eventually I was fully reimbursed.
That is, all my Orgovyx last year was provided at no charge. Same for this year too.
My Orgovyx was a "covered drug" on my Part D plan; with a 25% co-insurance.
I believe that a medication must be a "covered drug" under the Part D plan, and then your out of pocket for all "covered drugs" is capped at $ 2000.
I have some knowledge of Medicare, but I am not an expert.
Low income, people have been able to get the drug for free for a year from the manufacturer. There are also a lot of drug discounts for people who have lower income. You should ask your PCP/oncologist/urologist about this.
Most Part D plans cover it but you should check with your individual plan. Starting this year, the maximum out of pocket cost for all prescription drugs on Medicare is $2,000 so even if you have a Part D plan that doesn't cover it once you meet the $2,000 you won't pay any more than that.
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If you're eligible, ,The Assistance Fund might be able to help...
https://tafcares.org/patients/eligibility/
Last year, I applied too late to avoid an initial US$1000 copay. Thru TAF, eventually I was fully reimbursed.
That is, all my Orgovyx last year was provided at no charge. Same for this year too.
-
Like -
Helpful -
Hug
3 ReactionsThank you for the information!
My Orgovyx was a "covered drug" on my Part D plan; with a 25% co-insurance.
I believe that a medication must be a "covered drug" under the Part D plan, and then your out of pocket for all "covered drugs" is capped at $ 2000.
I have some knowledge of Medicare, but I am not an expert.
-
Like -
Helpful -
Hug
2 ReactionsLow income, people have been able to get the drug for free for a year from the manufacturer. There are also a lot of drug discounts for people who have lower income. You should ask your PCP/oncologist/urologist about this.
-
Like -
Helpful -
Hug
6 ReactionsWell that’s good to know . Thanks. 😊
Most Part D plans cover it but you should check with your individual plan. Starting this year, the maximum out of pocket cost for all prescription drugs on Medicare is $2,000 so even if you have a Part D plan that doesn't cover it once you meet the $2,000 you won't pay any more than that.
-
Like -
Helpful -
Hug
3 Reactions