Heavens. The stuff is $18,690 per dose, which can be reduced to $5, depending on things I don’t know.
Ms. Napier has been using Tremfya. We have decent insurance which has been covering it.
But I’m retiring, and we haven’t figured out Medicare, Medigap, Medicare Advantage, etc etc etc. The manufacturer has an assistance program but we’re a little above the household max income to quality for it. Getting Tremfya is her top priority.
How do people get this paid for? And, especially, are there any mistakes we could make at this point that will really mess this up?
Try digging around in the manufacturer’s assistance site. They seem to have more then one avenue for getting help with the cost. One of the saving plans specifically stated there were no household income limits.
The trick will be when you go on Medicare and a Medicare drug plan-which will complicate the assistance from Janssen. When choosing a part D drug plan you can plug in your meds and find out which plan pays for which drug at which level. Choose carefully and definitely don’t go anywhere near even considering a Medicare Advantage plan.