What Medicare doesn’t cover…
If you or a loved one has a rare disease that requires unique medications not covered by any Medicare plan, please do not ever give up looking for assistance! While I am not an expert on medical insurance, I learn more every year. It is that time of year where I have to stick with what I’ve been doing or see if there is another prescription plan that would be more beneficial, otherwise known as Open Enrollment.
Personally, I am trying a Medicare Advantage Plan this year. There are several preventative advantages to be gained that will help me pay for alternatives to pain medication. For instance, I’ll receive a pass to use the YMCA arthritis aqua classes. There will be a discount for over-the-counter medicines I take for allergies and medical supplies I need regularly. Massage therapy and chiropractic care are also included with this Advantage Plan.
Since there isn’t a Medicare prescription plan that covers the medicine that I take to control M.S. exacerbations, I continue to fill out tons of forms to apply for financial assistance. The retail price of my rare medication is $4000 a month. If my co-pay is 20% then I pay $200 a month. That is 2 weeks of food for myself and my companion dog. Through the years, I’ve received assistance from the National Organization for Rare Diseases, Chronic Disease Fund, and Assistance Fund. Each year I fill out a small mountain of paperwork to find funding for my prescription. Then I pray the fund still has money to give.
I want to encourage parents and family to keep fighting and asking questions for alternative funding sources. I dread this time of year like you do. Wondering if the funding will be there? Hoping that there is a back-up funding source if the organization folds. My advice…do not ever, ever, ever, ever give up.