› Forums › General Melanoma Community › Another interferon question, this time insurance-related.
- This topic has 63 replies, 10 voices, and was last updated 13 years, 1 month ago by
JC.
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- October 14, 2012 at 6:33 pm
Oh, to have had a crystal ball and changed insurance plans six months ago when the opportunity presented itself! But, as an ultra-healthy family, we've been comfortable for years with our coverage. It's a very basic plan and met our needs, but it doesn't include prescription drug coverage. I've only realized that this means the low-dose interferon won't be picked up by our insurance.
Oh, to have had a crystal ball and changed insurance plans six months ago when the opportunity presented itself! But, as an ultra-healthy family, we've been comfortable for years with our coverage. It's a very basic plan and met our needs, but it doesn't include prescription drug coverage. I've only realized that this means the low-dose interferon won't be picked up by our insurance.
Yes, in the ongoing ridiculousness that is health insurance, the high-dose (administered daily at the infusion oncology clinic) is covered. The low-dose (second phase, administered at home) is not. And I can only imagine the price tag on this stuff.
Have any of you here been in this situation? If so, how did you handle it? Thank you! Tomorrow's the Big Day, btw, when Hans will begin treatment. Call me crazy, but I'm on pins and needles. Just want to get going with it already, kwim?!
Warmly,
Colleen
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- October 14, 2012 at 6:43 pm
Some studies show the one month high dose is as effective as the 11 month low dose. Why not try the high dose since it is covered and see if he can tolerate it. If not, he has lost nothing.
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- October 14, 2012 at 6:55 pm
Yes, he's definitely starting the high dose treatment tomorrow and we'll see how that goes. Just wondering if anyone else has dealt with this particular insurance issue. Thanks! : )
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- October 15, 2012 at 5:54 am
To reiterate, he's beginning the interferon treatment tomorrow. He's not participating in a trial for a variety of reasons.
Thanks,
Colleen
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- October 15, 2012 at 5:54 am
To reiterate, he's beginning the interferon treatment tomorrow. He's not participating in a trial for a variety of reasons.
Thanks,
Colleen
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- October 15, 2012 at 5:54 am
To reiterate, he's beginning the interferon treatment tomorrow. He's not participating in a trial for a variety of reasons.
Thanks,
Colleen
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- October 14, 2012 at 6:55 pm
Yes, he's definitely starting the high dose treatment tomorrow and we'll see how that goes. Just wondering if anyone else has dealt with this particular insurance issue. Thanks! : )
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- October 14, 2012 at 6:55 pm
Yes, he's definitely starting the high dose treatment tomorrow and we'll see how that goes. Just wondering if anyone else has dealt with this particular insurance issue. Thanks! : )
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- October 14, 2012 at 10:39 pm
Yes, there have been some studies showing just the high dose is needed to extend the recurrence time. Overall survival though isn't effected with either high dose or low dose. Probably lot of insurance companies will stop covering it cause of the cost. Thousands of dollars monthly, I saw $30,000 for the medicine alone not including doctors fees and all the drugs you need to take counteract the side affects.
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- October 14, 2012 at 10:39 pm
Yes, there have been some studies showing just the high dose is needed to extend the recurrence time. Overall survival though isn't effected with either high dose or low dose. Probably lot of insurance companies will stop covering it cause of the cost. Thousands of dollars monthly, I saw $30,000 for the medicine alone not including doctors fees and all the drugs you need to take counteract the side affects.
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- October 15, 2012 at 2:25 am
I think I've seen others in here contact the maker of the drug and see if they can help. I would also ask his doctor as they often know other ways around red tape. When I did interferon the cost of the first month was just over $35,000 and each prescription for the low dose was $3,268 and that was in 2001/2002 but my insurance paid most of it. I'll keep my fingers crossed that somethng can be worked out for you.
You know Cooper, I'm thinking she didn't need the negative comment about survival rates when her husband is about to start this treatment. Do you do this when someone starts Yervoy – which right now shows an extended survival of a few months? Do you realize that all any cancer patient can reasonably expect is delayed recurrence? We want to delay delay delay until they DO have a treatment that gets rid of it. So far my delay is over 11 years and I consider the interferon I took a pretty good deal. Sheesh.
DebbieH, stage IIIC, NED 11+ years after interferon
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- October 15, 2012 at 2:25 am
I think I've seen others in here contact the maker of the drug and see if they can help. I would also ask his doctor as they often know other ways around red tape. When I did interferon the cost of the first month was just over $35,000 and each prescription for the low dose was $3,268 and that was in 2001/2002 but my insurance paid most of it. I'll keep my fingers crossed that somethng can be worked out for you.
You know Cooper, I'm thinking she didn't need the negative comment about survival rates when her husband is about to start this treatment. Do you do this when someone starts Yervoy – which right now shows an extended survival of a few months? Do you realize that all any cancer patient can reasonably expect is delayed recurrence? We want to delay delay delay until they DO have a treatment that gets rid of it. So far my delay is over 11 years and I consider the interferon I took a pretty good deal. Sheesh.
DebbieH, stage IIIC, NED 11+ years after interferon
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- October 15, 2012 at 9:55 pm
We are speaking here of cancer that has spread, cancer where you need treatment. If you are stage 1 I would hope you aren't thinking everything here applies to you. When I was stage 1A this board would have scared the hell out of me.
DebbieH, stage IIIC, NED 11+ years after interferon.
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- October 15, 2012 at 9:55 pm
We are speaking here of cancer that has spread, cancer where you need treatment. If you are stage 1 I would hope you aren't thinking everything here applies to you. When I was stage 1A this board would have scared the hell out of me.
DebbieH, stage IIIC, NED 11+ years after interferon.
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- October 15, 2012 at 9:55 pm
We are speaking here of cancer that has spread, cancer where you need treatment. If you are stage 1 I would hope you aren't thinking everything here applies to you. When I was stage 1A this board would have scared the hell out of me.
DebbieH, stage IIIC, NED 11+ years after interferon.
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- October 16, 2012 at 4:44 am
"We are speaking here of cancer that has spread, cancer where you need treatment. If you are stage 1 I would hope you aren't thinking everything here applies to you."
Right, and I heard and appreciated your earlier remarks in this context, Debbie. Thanks! : )
Warmly,
Colleen
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- October 16, 2012 at 4:44 am
"We are speaking here of cancer that has spread, cancer where you need treatment. If you are stage 1 I would hope you aren't thinking everything here applies to you."
Right, and I heard and appreciated your earlier remarks in this context, Debbie. Thanks! : )
Warmly,
Colleen
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- October 16, 2012 at 4:44 am
"We are speaking here of cancer that has spread, cancer where you need treatment. If you are stage 1 I would hope you aren't thinking everything here applies to you."
Right, and I heard and appreciated your earlier remarks in this context, Debbie. Thanks! : )
Warmly,
Colleen
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- October 15, 2012 at 5:03 pm
Yikes! $3268 for each low-dose prescription (10+ years ago) is pretty darn pricey! I will look into contacting the drug maker and talk more with the doctors and others at the infusion clinic. Thanks for your response, Debbie.
Best to you,
Colleen
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- October 15, 2012 at 5:03 pm
Yikes! $3268 for each low-dose prescription (10+ years ago) is pretty darn pricey! I will look into contacting the drug maker and talk more with the doctors and others at the infusion clinic. Thanks for your response, Debbie.
Best to you,
Colleen
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- October 15, 2012 at 5:03 pm
Yikes! $3268 for each low-dose prescription (10+ years ago) is pretty darn pricey! I will look into contacting the drug maker and talk more with the doctors and others at the infusion clinic. Thanks for your response, Debbie.
Best to you,
Colleen
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- October 15, 2012 at 2:25 am
I think I've seen others in here contact the maker of the drug and see if they can help. I would also ask his doctor as they often know other ways around red tape. When I did interferon the cost of the first month was just over $35,000 and each prescription for the low dose was $3,268 and that was in 2001/2002 but my insurance paid most of it. I'll keep my fingers crossed that somethng can be worked out for you.
You know Cooper, I'm thinking she didn't need the negative comment about survival rates when her husband is about to start this treatment. Do you do this when someone starts Yervoy – which right now shows an extended survival of a few months? Do you realize that all any cancer patient can reasonably expect is delayed recurrence? We want to delay delay delay until they DO have a treatment that gets rid of it. So far my delay is over 11 years and I consider the interferon I took a pretty good deal. Sheesh.
DebbieH, stage IIIC, NED 11+ years after interferon
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- October 15, 2012 at 4:53 pm
Cooper, whether or not a lot of insurance companies will stop covering interferon isn't pertinent to my question. As far as whether the high dose alone is as effective as the full treatment, the reality of course is that we really don't know. If my husband tolerates the drug reasonably well, he would prefer to run the course if possible. Thanks for replying. : )
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- October 15, 2012 at 4:53 pm
Cooper, whether or not a lot of insurance companies will stop covering interferon isn't pertinent to my question. As far as whether the high dose alone is as effective as the full treatment, the reality of course is that we really don't know. If my husband tolerates the drug reasonably well, he would prefer to run the course if possible. Thanks for replying. : )
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- October 15, 2012 at 4:53 pm
Cooper, whether or not a lot of insurance companies will stop covering interferon isn't pertinent to my question. As far as whether the high dose alone is as effective as the full treatment, the reality of course is that we really don't know. If my husband tolerates the drug reasonably well, he would prefer to run the course if possible. Thanks for replying. : )
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- October 14, 2012 at 10:39 pm
Yes, there have been some studies showing just the high dose is needed to extend the recurrence time. Overall survival though isn't effected with either high dose or low dose. Probably lot of insurance companies will stop covering it cause of the cost. Thousands of dollars monthly, I saw $30,000 for the medicine alone not including doctors fees and all the drugs you need to take counteract the side affects.
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- October 14, 2012 at 10:40 pm
Yes, there have been some studies showing just the high dose is needed to extend the recurrence time. Overall survival though isn't effected with either high dose or low dose. Probably lot of insurance companies will stop covering it cause of the cost. Thousands of dollars monthly, I saw $30,000 for the medicine alone not including doctors fees and all the drugs you need to take counteract the side affects.
-
- October 14, 2012 at 10:40 pm
Yes, there have been some studies showing just the high dose is needed to extend the recurrence time. Overall survival though isn't effected with either high dose or low dose. Probably lot of insurance companies will stop covering it cause of the cost. Thousands of dollars monthly, I saw $30,000 for the medicine alone not including doctors fees and all the drugs you need to take counteract the side affects.
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- October 14, 2012 at 10:40 pm
Yes, there have been some studies showing just the high dose is needed to extend the recurrence time. Overall survival though isn't effected with either high dose or low dose. Probably lot of insurance companies will stop covering it cause of the cost. Thousands of dollars monthly, I saw $30,000 for the medicine alone not including doctors fees and all the drugs you need to take counteract the side affects.
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- October 14, 2012 at 11:35 pm
I had to fight my insurance and after 4 weeks they agreed to pay but my doctor allowed me to do the self injection at the clinic through their pharmacy for the first 3 weeks to get around my insurance. I don’t know if that is a option but you can ask your doctor.
Just to let you know I did the 4 weeks of high dose and started the 11 months of low dose. I stoped the low dose after 2 months as I felt my quality of life was worth more than the little if any benefit from the low dose.
Just my two cents
Peter
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- October 14, 2012 at 11:35 pm
I had to fight my insurance and after 4 weeks they agreed to pay but my doctor allowed me to do the self injection at the clinic through their pharmacy for the first 3 weeks to get around my insurance. I don’t know if that is a option but you can ask your doctor.
Just to let you know I did the 4 weeks of high dose and started the 11 months of low dose. I stoped the low dose after 2 months as I felt my quality of life was worth more than the little if any benefit from the low dose.
Just my two cents
Peter
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- October 15, 2012 at 4:57 pm
I hadn't thought about doing the self-injection at the clinic (at least temporarily); thanks for mentioning this, Peter, and for your input.
Best to you,
Colleen
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- October 15, 2012 at 4:57 pm
I hadn't thought about doing the self-injection at the clinic (at least temporarily); thanks for mentioning this, Peter, and for your input.
Best to you,
Colleen
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- October 15, 2012 at 4:57 pm
I hadn't thought about doing the self-injection at the clinic (at least temporarily); thanks for mentioning this, Peter, and for your input.
Best to you,
Colleen
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- October 14, 2012 at 11:35 pm
I had to fight my insurance and after 4 weeks they agreed to pay but my doctor allowed me to do the self injection at the clinic through their pharmacy for the first 3 weeks to get around my insurance. I don’t know if that is a option but you can ask your doctor.
Just to let you know I did the 4 weeks of high dose and started the 11 months of low dose. I stoped the low dose after 2 months as I felt my quality of life was worth more than the little if any benefit from the low dose.
Just my two cents
Peter
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- October 15, 2012 at 12:30 am
I’m not too familiar with interferon (my husband is stage 4), but what about checking with the drug company? We have received assistance directly through the drug company for both Zelboraf and Yervoy. Right now, we only pay 20% for the Zelboraf. You might check with your oncologist…they should have someone in the office who can help you find assistance for the medication. -
- October 15, 2012 at 12:30 am
I’m not too familiar with interferon (my husband is stage 4), but what about checking with the drug company? We have received assistance directly through the drug company for both Zelboraf and Yervoy. Right now, we only pay 20% for the Zelboraf. You might check with your oncologist…they should have someone in the office who can help you find assistance for the medication.-
- October 15, 2012 at 3:23 pm
Thanks for this suggestion, jmmm. I am thinking maybe there's more willingness on the part of the drug company to help pay for Zelboraf as it's a newer drug…? Perhaps not. I'll look into this. And yes, I need to talk with the people at the infusion clinic and the oncologists' office as well and see if they have suggestions.
Best to you,
Colleen
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- October 15, 2012 at 3:23 pm
Thanks for this suggestion, jmmm. I am thinking maybe there's more willingness on the part of the drug company to help pay for Zelboraf as it's a newer drug…? Perhaps not. I'll look into this. And yes, I need to talk with the people at the infusion clinic and the oncologists' office as well and see if they have suggestions.
Best to you,
Colleen
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- October 15, 2012 at 3:23 pm
Thanks for this suggestion, jmmm. I am thinking maybe there's more willingness on the part of the drug company to help pay for Zelboraf as it's a newer drug…? Perhaps not. I'll look into this. And yes, I need to talk with the people at the infusion clinic and the oncologists' office as well and see if they have suggestions.
Best to you,
Colleen
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- October 15, 2012 at 12:30 am
I’m not too familiar with interferon (my husband is stage 4), but what about checking with the drug company? We have received assistance directly through the drug company for both Zelboraf and Yervoy. Right now, we only pay 20% for the Zelboraf. You might check with your oncologist…they should have someone in the office who can help you find assistance for the medication. -
- October 15, 2012 at 12:42 pm
Oh, Colleen! I am so sorry that you and your family have to go through all this! As if the cancer, the children, the business, the transportation, and the side effects aren't enough to cope with, now you have to worry about having to PAY for the treatment! And so many people lose their homes and their businesses trying to pay for health care in this country, It's not right; it's just not right. I wish I had some really helpful information to give you about fighting your insurance company, but I don't. You just have my deepest respect and sympathy.
I was reading a travel article the other day and was struck by one sentence: "I’m haunted by the image of Rebecca, a 13-year-old girl, writhing in pain on a clinic bed; her father looking on with as much agony etched on his own face. 'The medicine is there,' he told me, 'but I can’t afford it.'" Tellingly, the author (a Canadian) was talking about the horrible conditions of life in Ghana. Oh, the shame for us in the States!
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- October 15, 2012 at 12:42 pm
Oh, Colleen! I am so sorry that you and your family have to go through all this! As if the cancer, the children, the business, the transportation, and the side effects aren't enough to cope with, now you have to worry about having to PAY for the treatment! And so many people lose their homes and their businesses trying to pay for health care in this country, It's not right; it's just not right. I wish I had some really helpful information to give you about fighting your insurance company, but I don't. You just have my deepest respect and sympathy.
I was reading a travel article the other day and was struck by one sentence: "I’m haunted by the image of Rebecca, a 13-year-old girl, writhing in pain on a clinic bed; her father looking on with as much agony etched on his own face. 'The medicine is there,' he told me, 'but I can’t afford it.'" Tellingly, the author (a Canadian) was talking about the horrible conditions of life in Ghana. Oh, the shame for us in the States!
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- October 15, 2012 at 3:19 pm
Thank you, POW, for empathizing. Yes, it's a tangled web we Americans weave, this insurance mess. Nicholas Kristof addresses that very thing in his Sunday column (NY Times) this week.
Best to you,
Colleen
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- October 15, 2012 at 3:19 pm
Thank you, POW, for empathizing. Yes, it's a tangled web we Americans weave, this insurance mess. Nicholas Kristof addresses that very thing in his Sunday column (NY Times) this week.
Best to you,
Colleen
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- October 15, 2012 at 3:19 pm
Thank you, POW, for empathizing. Yes, it's a tangled web we Americans weave, this insurance mess. Nicholas Kristof addresses that very thing in his Sunday column (NY Times) this week.
Best to you,
Colleen
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- October 15, 2012 at 12:42 pm
Oh, Colleen! I am so sorry that you and your family have to go through all this! As if the cancer, the children, the business, the transportation, and the side effects aren't enough to cope with, now you have to worry about having to PAY for the treatment! And so many people lose their homes and their businesses trying to pay for health care in this country, It's not right; it's just not right. I wish I had some really helpful information to give you about fighting your insurance company, but I don't. You just have my deepest respect and sympathy.
I was reading a travel article the other day and was struck by one sentence: "I’m haunted by the image of Rebecca, a 13-year-old girl, writhing in pain on a clinic bed; her father looking on with as much agony etched on his own face. 'The medicine is there,' he told me, 'but I can’t afford it.'" Tellingly, the author (a Canadian) was talking about the horrible conditions of life in Ghana. Oh, the shame for us in the States!
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- October 16, 2012 at 4:49 pm
I don't know if this will help or not as my husband only did the 1 month infusions and decided against the 11 months injections but if nothing else works, go to someone in the hospital that deals with the billing and finances and talk to them about your situation. Sometimes you can get help with stuff just by asking someone. They can often times find programs to help you, give you big discounts, affordable payment plans. You may have to fill out paperwork to get the help but i think it would be worth your time. Hey, even a reasonable payment plan or whatever discount they may give you is better than nothing!
Mandi
Husband stage 3b
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- October 16, 2012 at 4:49 pm
I don't know if this will help or not as my husband only did the 1 month infusions and decided against the 11 months injections but if nothing else works, go to someone in the hospital that deals with the billing and finances and talk to them about your situation. Sometimes you can get help with stuff just by asking someone. They can often times find programs to help you, give you big discounts, affordable payment plans. You may have to fill out paperwork to get the help but i think it would be worth your time. Hey, even a reasonable payment plan or whatever discount they may give you is better than nothing!
Mandi
Husband stage 3b
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- October 16, 2012 at 4:49 pm
I don't know if this will help or not as my husband only did the 1 month infusions and decided against the 11 months injections but if nothing else works, go to someone in the hospital that deals with the billing and finances and talk to them about your situation. Sometimes you can get help with stuff just by asking someone. They can often times find programs to help you, give you big discounts, affordable payment plans. You may have to fill out paperwork to get the help but i think it would be worth your time. Hey, even a reasonable payment plan or whatever discount they may give you is better than nothing!
Mandi
Husband stage 3b
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- October 17, 2012 at 2:43 pm
In 2006, one-quarter of cancer patients reported that they had used up all or most of their savings paying for care; a study last year reported that 2 percent of cancer patients were driven into bankruptcy by their illness and its treatment. One in 10 cancer patients now reports spending more than $18,000 out of pocket on care.
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- October 17, 2012 at 2:43 pm
In 2006, one-quarter of cancer patients reported that they had used up all or most of their savings paying for care; a study last year reported that 2 percent of cancer patients were driven into bankruptcy by their illness and its treatment. One in 10 cancer patients now reports spending more than $18,000 out of pocket on care.
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- October 17, 2012 at 2:43 pm
In 2006, one-quarter of cancer patients reported that they had used up all or most of their savings paying for care; a study last year reported that 2 percent of cancer patients were driven into bankruptcy by their illness and its treatment. One in 10 cancer patients now reports spending more than $18,000 out of pocket on care.
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