Today I did two runs with ms. The first one was much more enjoyable despite teh chilly morning and having drank something called Bad Road at a local restaurant. Piece of advice when drinking a Bad Road, when they ask if you want 10 mile or 5 miles, don’t respond with “10”. So the run went pretty well, a base run of 5.75 miles. It was sunny out as it usually is when it is that cold in Portland and that kept me going strong.
One thing that I found interesting from a radio station I was listening to: Portland was named the #1 most unhappy city in the US by Business Week. I think it is really funny as I know Portlanders are going to get all “unhappy” about it. To me it is good news as it means fewer people will be coming here and clogging up our roads. Won’t do much for my clients that rely on tourism though. In truth Portland is a pretty optimistic place if not overly so. They don’t call us the city of rose(colored glasses)s for nothing.
So my second run(around) with ms happened later this afternoon. I am ending my one year of free rebif from Serano and MS Lifelines. Thanks for the free drugs, I’m sure they have been a help to my situation. The down side to having hope with ms, is that to continue having hope I will have to shell out over $2000 a month for the rest of my life. Turns out the medical assistance program they offer after the first year has very low income requirements which I don’t fall under. I make too much to get assistance, but not enough to be able to afford it.
So I know all of you are asking, come on Marco, you have ms, don’t you have insurance? Well yes I do. Turned out the plan that I originally purchased and read to cover prescriptions doesn’t cover “specialty” medications such as rebif. No soup for you! Healthnet actually will cover up to $4K of “specialty” meds which almost takes me through February every year. Nice job Healthnet, you got me covered! The day I found out about this I just about pooped myself. After several phone calls I found out about the MS Lifelines Access Made Simple program which provides ms patients with free (or nearly free) rebif for a year and then offers assistance after the first year. I was so relieved. Well, it turned out I just put off the pooping a year. As I said earlier, I don’t qualify for further help.
So what to do now? And let the run around begin! I have always gotten really good help from MS Lifelines. Their call center was always helpful and easy to understand. Well, that is until you get transferred out to fulfillment or in today’s case Assistance Program. Seems like a change of company or at the very least pay scale as the service level drops off significantly. Part of me has to wonder if Serano wouldn’t do more for me if I just got to speak to someone else.
My first thought is to get on Ruthann’s insurance, which would “only” run me $800+ a month Good insurance though, eye, ear throat, the whole deal. Well at least that would be my final option. But still not a concretely solution.
So cut adrift I look into the Oregon Prescription Drug Program, a program to lower the cost of prescription drugs. When I first found out about the cost of rebif it was $1800 a month. With OPDP teh cost was lowered to $2300 a month. Oh wait, that is more? Has their been a huge increase in the cost of rebif in a year? Not out of the realm of possibility. I ask if there are other programs that I could try and after some searching she replied, Oh yes there is “the MSLifelines program that will…” Grrrrr. So I call Partner for Prescription Assistance, they also tell me of the low. low price of $2300 a month AND if I order by mail I can get it for only $2000 a month. In addition there is this program called “MSLifelines that will…” Next I try RX Assist and Needy Meds which both tell me of a program called “MSLifelines that will…”. Needy Meds does tell me of several drug card programs that are available: Drug Card America, Patient Card (or something like that), Free Drug Card, PS Card and True RX Services. All of which had websites that looked as if I was going to be ordering a set of knives or Obama coin sets. Id did appear that I could get some sort of discount through them. So now I am down to about $1500 a month.
Not to be discouraged I call on my last hope the Oregon Medical Insurance Pool. This group covers individuals as if they were a group. But, because I have MS, my costs would be pretty high. The woman (Mary) I talked with was very honest about this. In fact if I got the $500 deductible plan, my meds might cost me as much as $40 a month and the plan itself could be as much as $436 a month. She paused for the shock of the high cost to ease from my shoulders. I think I totally surprised her when I said, “Wow that’s great!” Great? she replied. When I told her the cost of my meds I think it made her feel really good to have been such a help. My next question was a doozy though, did OMIP consider rebif a specialty drug and were there any constraints associated with it. After being on hold four separate times she came back to say she wasn’t positive, but it appeared there weren’t. I was just relieved I could afford that, best news I had gotten all day. She promised to send me info on the plan. I think I have a winner.
When I was on medication I got a reduced medication from Avonex directly. All I had to pay was the shipment. First time out it was a one month supply, then it was a 3 month supply.
I am no longer using any medication but try getting in touch with Rebif directly. Who knows?!
Hi, I did get in touch with Serano, the pharm that makes it. They actually paid for the entire first year of my rebif, but I don’t qualify for anything further they offer. I did find success with the Oregon Medical Insurance Pool, even though it is a higher premium. But they cover rebif, so there you go.
I forgot to ask, how is the no medication going? I think about you and doing that myself often.