MAPD Part B chemo drugs 20%

[Medicare bro]

I have never seen an advantage plan cover more than 20% for cancer chemo meds. Is this because the cost is low? Or if someone gets cancer they will hit the MOOP. I’ve always wondered about cost on this. Thanks

 

[rmhaire]

I have never seen an advantage plan cover more than 20% for cancer chemo meds. Is this because the cost is low? Or if someone gets cancer they will hit the MOOP. I’ve always wondered about cost on this. Thanks

You'll hit your moop pretty fast.

As for the cost, the next time you see someone getting one of those compounded cancer iv's, you're looking at over ten grand each.

 

[annon123]

When I had 4 rounds of chemo (IV 2 drugs 8 hours one day and 4 hours the next with a repeat of one of the two drugs) the total (including 3 nuelasta shots done at the oncologist's clinic) came to just over $178,000 (negotiated rate, state employer insurance managed by BCBS; they paid 80% and I hit my out of pocket limit after one round). Luckily for me I was in remission when it had to be stopped due to side effects because otherwise I'd have had 2 more rounds.

 

[Fisher]

I have never seen an advantage plan cover more than 20% for cancer chemo meds.

You have it backwards. The MAPD pays 80%, the chemo patient pays 20% until MOOP.

 

[rmhaire]

When I had 4 rounds of chemo (IV 2 drugs 8 hours one day and 4 hours the next with a repeat of one of the two drugs) the total (including 3 nuelasta shots done at the oncologist's clinic) came to just over $178,000 (negotiated rate, state employer insurance managed by BCBS; they paid 80% and I hit my out of pocket limit after one round). Luckily for me I was in remission when it had to be stopped due to side effects because otherwise I'd have had 2 more rounds.

First of all, I'm sorry to hear you had to go through that crap. I hope you beat it.

I've never had cancer but plenty of my family members have.

The number I quoted is a number I got from my son. Tomorrow morning he'll be down at the local hospital compounding those very same drugs we're talking about.

He told once that his hands actually shake when he starts to compound one. When I asked him why he told me it's because he knows how much it's going to cost the patient he's preparing it for.

Again. Hope you're doing ok and have beat it.

 

[annon123]

First of all, I'm sorry to hear you had to go through that crap. I hope you beat it.

I've never had cancer but plenty of my family members have.

The number I quoted is a number I got from my son. Tomorrow morning he'll be down at the local hospital compounding those very same drugs we're talking about.

He told once that his hands actually shake when he starts to compound one. When I asked him why he told me it's because he knows how much it's going to cost the patient he's preparing it for.

Again. Hope you're doing ok and have beat it.

Thanks. I've had 3 major ones. One I am cured of, one likely cured of but it can recur even 30 years out (I am 14 years out knock on wood), and the third one is an indolent incurable blood cancer. With that I have passed the median split for relapse so clearly I am one of the lucky ones with that. Hopefully that will continue for a very long time. I was very lucky and out of state MD Anderson Cancer Center was in network so I could get the latest treatment (actual treatment done locally at home but I'd go back there periodically - still do for an annual check up) because locally the university medical center cancer clinic had never heard of it. A newer, better chemo with a higher remission rate.

Good thing there are people like your son who are careful concocting this stuff because so much depends on it being done right. Tell him people like me appreciate that.

 

[rmhaire]

Thanks. I've had 3 major ones. One I am cured of, one likely cured of but it can recur even 30 years out (I am 14 years out knock on wood), and the third one is an indolent incurable blood cancer. With that I have passed the median split for relapse so clearly I am one of the lucky ones with that. Hopefully that will continue for a very long time. I was very lucky and out of state MD Anderson Cancer Center was in network so I could get the latest treatment (actual treatment done locally at home but I'd go back there periodically - still do for an annual check up) because locally the university medical center cancer clinic had never heard of it. A newer, better chemo with a higher remission rate.

Good thing there are people like your son who are careful concocting this stuff because so much depends on it being done right. Tell him people like me appreciate that.

I'll do it. He'll appreciate it.

I'll be praying for you. Keep me posted.

 

[Medicare bro]

You have it backwards. The MAPD pays 80%, the chemo patient pays 20% until MOOP.

If it didn’t come across that way, that is what I meant.

 

[Medicare bro]

When I had 4 rounds of chemo (IV 2 drugs 8 hours one day and 4 hours the next with a repeat of one of the two drugs) the total (including 3 nuelasta shots done at the oncologist's clinic) came to just over $178,000 (negotiated rate, state employer insurance managed by BCBS; they paid 80% and I hit my out of pocket limit after one round). Luckily for me I was in remission when it had to be stopped due to side effects because otherwise I'd have had 2 more rounds.

Praying you have fully recovered my friend!

 

[Medicare bro]

You'll hit your moop pretty fast.

As for the cost, the next time you see someone getting one of those compounded cancer iv's, you're looking at over ten grand each.

I would imagine this would be the same if say someone gets really expensive transfusions often? I have a client that has rheumatoid arthritis and takes an infusion med that is 10,000 a pop.