Can Georgia seniors on Medicare afford their chemotherapy or will they have to go without? Now that chemotherapy is in pill form, will Medicare pay for it or are you left out in the cold?
Rita Moore went to fill her prescription for a kidney cancer drug only to discover her cost was $2400 . . . more than she makes each month.
Medicare prescription plans that cover seniors like Moore are allowed to charge steep copayments for the latest cancer drugs, which can cost tens of thousands of dollars a year. About 1 in 6 beneficiaries are not filling their prescriptions, according to recent research that suggests a worrisome trend.
Chemotherapy administered in the doctors office or a clinic is covered by Medicare Part B, but when you receive your medication in pill form Medicare Part D comes in to play.
Moore, 65, was operated on in February for an advanced form of kidney cancer. As she faced a life-and- death struggle, both her cancer and kidney specialists agreed a drug called Sutent offered the best chance. It’s a capsule you can take at home.
Certainly the convenience of taking the medication at home is nice but it comes at a price.
A price that is out of range for most Georgia seniors.
Some of the most expensive medications that are used to treat multiple sclerosis, rheumatoid arthritis, hepatitis C and cancer are “tiered” drugs where the patient is required to pay 25% of the cost of the drug. That is if you have Medicare Part D. If so, your Part D pays the other 75%.
Forty-six percent of Medicare beneficiaries faced copayments of more than $500, as compared with only 11 percent of patients with private insurance. Among people of all ages, 1 in 4 who faced a copayment over $500 did not fill their prescriptions. Cancer is more prevalent among older people.
Bad as this is, Medicare is broke. Seniors on Medicare must shoulder the cost of 52% of the cost of their care while Medicare pays the remainder.
Rita Moore had to try to find her own way out of the dilemma.
She decided to apply to Pfizer’s prescription assistance program for patients who can’t afford Sutent and other drugs the company makes. Pfizer approved a year’s worth of free medication, but it took about two months to collect and review all the medical and financial paperwork.
Georgia Medicare Plans has resources to help GA seniors cover the cost of their prescription medication. We can provide information on PAP’s (Patient Assistance Programs) such as SPIN.
Others can find tremendous savings through online pharmacy’s such as Blue Sky.
Georgia Medicare Plans is a leading resource for information on affordable Medicare supplement plans in Georgia.