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The drug is injected once a month, it's injectable Abilify. The client was referred due to agent and client missing December T65, now rejected by the ACA carrier back to Jan. 1.
The foundation for Abilify financial help is willing to pay for Feb, but after, it's related to whether the drug is covered by Part D. If not covered by Part D, the foundation will help. There will be more discussion with them later today.
So, if the drug is injected at a provider office, wouldn't it be claimed under Part B, like when a flu shot is given at a pharmacy or doc office?
The cost is anywhere from $1,500 to $3,000 per dose, so we are working on MedSupp cost being justified by $0 cost for drug if not self administered.
It's a narrow band of time, due to the clock ticking for PDP/MAPD IEP. Longer for Supp, but 20% on most MAPD's for Part B or the coverage gap is going to be several thousand per year still.
The foundation for Abilify financial help is willing to pay for Feb, but after, it's related to whether the drug is covered by Part D. If not covered by Part D, the foundation will help. There will be more discussion with them later today.
So, if the drug is injected at a provider office, wouldn't it be claimed under Part B, like when a flu shot is given at a pharmacy or doc office?
The cost is anywhere from $1,500 to $3,000 per dose, so we are working on MedSupp cost being justified by $0 cost for drug if not self administered.
It's a narrow band of time, due to the clock ticking for PDP/MAPD IEP. Longer for Supp, but 20% on most MAPD's for Part B or the coverage gap is going to be several thousand per year still.
