medicare part B-Pulmozyme

[anonymous]

Does anyone have Pulmozyme covered by medicare part B? I just found out the Part D won't cover it and now have to jump hoops to see who will, on top of that I am wondering how much will I have to pay out of pocket. UGH.

Sarah
27 w/cf

 

[anonymous]

According to this article on the CFF site <a target=_blank class=ftalternatingbarlinklarge href="http://www.cff.org/legislative_action/public_health_and_reimbursement/">http://www.cff.org/legislative...lth_and_reimbursement/</a> Medicare Part B will cover.
My experience is that Medicare part B covers anything that is delivered via a nebulizer.
-LisaV

 

[JustDucky]

Yep, Lisa is right. Medicare part B will cover Pulmozyme as well as nebulized albuterol, TOBI, Xopenex because you require a nebulizer to deliver the med (durable medical equipment) All of my nebs are currently being covered by part B. Hugs, Jenn <img src="i/expressions/face-icon-small-smile.gif" border="0">

 

[Jennifer1981]

Hi,

Medicare Part B paid for my Pulmozyme. I didn't have any copay or anything. No problems or hassles. Good luck!

Jenny 24 w/CF

 

[anonymous]

Jenny
I was told it would be a 20% copay, how do you have no copay. Do you go through a special pharmacy?

Thanks,

Sarah

 

[cfcndlelady]

Medicare part B Does cover my pulmozyme BUT I have to pay $287.96 for it out of my pocket!!! It's getting to the point I can't afford it!!

Caren 34 w/CF

 

[idajune]

Caren- Genentech has a program to help people who qualify with paying for the copayment. That is where I am right now, in the process of applying for it. From my pharmacy it is going to cost $345. Yuck.

 

[luke]

Under Medicare B, medicare requires that each patient meets their yearly dedictible and then 20% of the Medicare allowable. The only way a company can legally not charge you your copay is if they have a patient assistance program where you can apply for asssistance. Company's can get in trouble if they just don't bill the 20%. When they agree to accept medicare they agree to follow their rules, and that is one of them. Not to mention it isn't good business to leave that much money uncollected.

Let it be said that the 20% can be covered by a secondary insurance.



luke