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medicare prescription drug quandry
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medicare prescription drug quandry

› Forums › General Melanoma Community › medicare prescription drug quandry

  • Post
    • January 26, 2022 at 12:18 pm
    tkoss
    Participant
      i am on medicare as of last month. i have my 3rd and last scan for stage 3a next month. likely NED but who knows.

      i have to chose a prescription drug plan, teh cheapest at $6.90, the most expensive $68.20 /month

      my question: if i am NOT NED and need to go nivo + ipi are there other drugs that go along with that regime that are not covered by Part A and B medicare and that i would have to pay for. if so what are these likely drugs.

      if you can imagine the more esoteric the drug the more likley it would be Tier 3 under any precription drug plan and thus very expensive, thus i need to think about getting the higher priced plan

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    • Replies
        • January 27, 2022 at 6:14 pm
        ThinkingPositive
        Participant
          Hi Tkoss,
          Your oncologist or nurse may be able to guide you on potential treatment plans, but if you are pressed to make a decision I would recommend reading Celeste’s links to her library of research articles on treatments for those progressing to stage 4 (which I hope you are not)! I didn’t have to make the drug plan choice as it is part of my retiree Medicare Advantage. I think those immunotherapy drugs are under specialty drugs, my Keytruda needed auths through Evicore, a utilization management company.
          Cindy
            • January 30, 2022 at 4:31 pm
            tkoss
            Participant
              thanks, under medicare anything infused is covered by Part A & B.

              i was thinking about the other drugs that might be invovled if you are treated for Stage 4. pain or nausea or swelling or other palliative or complimentary drugs.

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