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Real members of myRAteam have posted questions and answers that support our community guidelines, and should not be taken as medical advice. Looking for the latest medically reviewed content by doctors and experts? Visit our resource section.

The letter states that now the patient will pay 20% of the cost of the chemotherapy medication and administration procedure. I am on Rituxan (chemotherapy med) infusions, and they are given 2 weeks apart. My infusions were billed to my work sponsored insurance which was an HMO as well at above $46,395.00 each. This would leave me with an out-of-pocket cost of $9200.00 for each. I called United Health Care and I received 2 different answers. One rep stated that this cost was on top of my yearly… read more

April 18, 2023
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Answer Summary

Members rallied around someone facing a shocking potential cost increase for Rituxan infusions under Medicare Advantage, sharing strategies to... Read more

Members rallied around someone facing a shocking potential cost increase for Rituxan infusions under Medicare Advantage, sharing strategies to navigate the confusing and often contradictory information from insurance representatives. Several members offered practical advice, including contacting pharmaceutical companies directly for patient assistance programs (with success stories of receiving medications for as little as $5 instead of thousands), comparing pharmacies for lower prices, enrolling in manufacturer co-pay cards, and exploring whether traditional Medicare with a supplement might provide better coverage than Advantage plans for expensive specialty medications. A recurring theme was frustration with the broken system where the same medication can cost anywhere from $5 to nearly $6,000 depending on the source, coupled with determination to advocate fiercely, research all options, and share hard-won knowledge to help fellow members survive impossible healthcare costs.

A myRAteam Member

No , I haven’t been notified of any increases of any medication (FYI - When I first started my Interferon treatment, my work insurance only covered generic medications) I had already ordered the medication (it was $3,900.00 for a month supply) I had just enough available credit on my Visa to cover the first month- after the Gastroenterologist called the medication supplier and inquired about any other options, they said they would donate the 9 months supply and enroll me in their “Be in charge” program @ their cost. You should contact the medication company and ask if they can get you in a financial assistance program. I’d then contact your insurance provider (United Healthcare Services has an AARP Medicare Advantage Plan that covers “non-formally” medications) I’ll be Praying for you to get some help. Light, Love & Hope 🌹🌹

April 18, 2023
A myRAteam Member

Be very cautious when considering a Medicare Advantage plan. As a former hospital case manager I saw numerous patients who couldn’t get the services they needed because the plan they chose would not approve them. I understand that they are cheaper than standard Medicare, but they are typically more restrictive about which providers you can see and what services they will approve. I don’t know that there’s a good answer to the drug costs. Medicare Part D is the drug coverage part of Medicare and from what I can tell all the part D options provide limited coverage for the more expensive meds that we need. Check and see if your state has some type health insurance assistance program that provides unbiased counseling and assistance in selecting the best coverage for you.

April 29, 2023
A myRAteam Member

Hi Grillo,

I attended a Medicare Seminar where they explain all of Medicare and the Advantage Plans available. I have a yearly $800 deductible. It seems we pay for an appointment where the doctors are in a hurry to get to the next patient. This makes it difficult to pay the fees for healthcare. During one of my appointments, I asked my Rheumatologist if we could agree on email communication when I need to ask questions. She agreed.

April 23, 2023
A myRAteam Member

I have to now re answer the question because I got a letter yesterday saying that the price on insulin would go up if I was using insulin which I am not, but I was wondering if it would affect my ozempic or not, I have no copay on any of my meds and it’s not insulin I don’t think it is but if it is then I will have to pay $35 monthly from 0 to $35 is a big jump 🤷🏾‍♀️ but hey it could be worse.

April 19, 2023
A myRAteam Member

I get my Humira directly from the pharmaceutical company. It is $5.00 per month. Gold RX was $5,900.00 per month. Blue Cross was $5,975.00 per month.

I wish the government would slap down these insurance and pharmaceutical companies. $5.00 to almost $6,000 a month clearly shows we have a serious problem.

April 19, 2023

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