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Most I have looked at require 25% to 33% co-payment for Gleevec if it is in
Tier 4 after the donut hole is met. At least that is my understanding of it at
this point. If that is correct it would translate into $15,000 a year and up in
co-payments for Gleevec.
Rob
----- Original Message -----
Sent: Sunday, December 04, 2005 6:16
PM
Subject: [CML] Re: Aetna & Other
Medicare Plans
--- In [email protected], Rob <[EMAIL PROTECTED]...> wrote:
"Has anyone found a Medicare
prescription drug plan yet that covers
Gleevec without a large deductible
and co-payment. We have been
comparing various plans and most consider
Gleevec as a Tier 4 drug and
require a co-pay of 25% to 33% which would
push the annual out of
pocket costs for just Gleevec to as high as $15,000
a year (or even
higher for those who are on high doses).
The only
one we have found so far which does not have Gleevec in Tier
4 is Aetna.
Has anyone had any experience with them and was it
difficult to get them to
certify Gleevec as a drug (it has to be
approved by
them).
Rob"
Rob,
Well, I've checked out about 10 plans now and,
you're right, most of
them have Gleevec in Tier 4 (I wish someone would
explain what "tier"
means). Except for Blue Cross which places
Gleevec in Tier 2 and the
monthly co-pay is $25 or $30, depending on which
Blue Cross plan you
sign up for. But, of course, that's Blue Cross
of California so I
have no idea what other state's Blue Cross coverage
would be. I also
saw that Aetna Medicare Rx Premier (premiums are
$51.84 a month vs
Blue Cross' $35.29) has Gleevec in Tier 3 at $40 a month
co-pay. Blue
Cross and Aetna's annual deductible are both $0.00.
But I don't understand what you mean about an annual out of pocket
cost as high as $15,000, when I thought a patient only had to pay 5%
after the so-called "donut hole" was met.
Nancy B from California
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