Usually, people obtain Private Insurance by way of their employer, and it will vary wildly from the gold plated programs to very basic plans with high deductibles, high co pay percents, and high monthly employee costs to participate. If you have one of the better plans,like that for union railway workers, they still pay 21%(CLICK HERE for the source) of their yearly health care costs. It is likely most insured would find it difficult to afford the high cost of myeloma treatment, which can easily approach $626,000 in the first year without additional financial assistance. The cost of insurance, co pays, and deductibles can easily reach $20 to $30 thousand in the first year alone.
So with or without insurance how do you afford the shortfall?
The non insured need to find a way to get insured as soon as possible. The Affordable Care Act (ObamaCare) is one possibility, however open enrollment period is usually only two months long and you may need help now. CLICK HERE to view the ACA program details. You may apply for Medicaid and obtain coverage, and if turned down for Medicaid you are then eligible to apply for the ACA program at any time during the year. CLICK HERE. Finally you can get Medicare and that is what I and many other myeloma patients have done. If you do not have insurance or have no access to care, the average life expectancy is less than one year. However, Medicare has a Compassionate Allowance Program where you can be approved in less than two weeks if you go to your local office and can show that you will not live without care. To see the program CLICK HERE.
So now the uninsured are insured, and fall in the same category as the insured! How then does this group obtain the funds to handle the cost of Insurance, co pays, deductibles, and high cost of myeloma treatment and drugs?
First of all go back to Part 1 of this series (CLICK HERE) and take advantage of all the third party co pay programs which you qualify for. Just note a few are listed as just for Medicare patients. You can find a listing of all of these co pay programs if you CLICK HERE.
Second, and this is a great benefit for all who have private insurance, or if you want treatment and are not yet insured this may apply to you. The drug companies can provide direct copay funding to anyone who has no insurance, or private insurance. Drug companies want you to take their drugs and would love to do the same for Medicare and Medicaid patients, but their misguided effort to ensure these programs only use generic drugs has also affected most cancer drugs which have few if any generics. The solution to this would be to exclude all patented and or cancer drugs without a generic equivalent from this ruling which DISCRIMINATES against senior and disabled cancer patients! Most of these programs have income limits but Celgene has recently removed their income limit requirement. The following are links to drug sponsored co-pay assistance programs. Just click on the red highlighted lines.
- Thalomid, Revlimid, & Pomalyst
- Celgene patient support web portal
- Amgen Assist 360 Program
- Janssen CarePath Program