[CML] Gleevec

[Margot M]

I have checked on several of the plans that are available in Kansas and found that Gleevec with all of them falls into the Specialty Drug category.  There is a 25% co-payment till you reach $2250 and then from that point on to $3600 we pay full price.  After $3600 we only pay 5%, which means that at 400 mg daily we would be covered by the catastrophic coverage in less than 2 months.  That's the way I understand it to be.  If anyone know different, I would like to know.   Each state has different plans available and some don't pay for Gleevec at all.  I have checked out several for Kansas and Coventry doesn't pay for Gleevec at all.  Humana and AARP do pay for it, in each case it falls into the specialty bracket, quantity limited.  I checked out the quantity limit with AARP--that simply means that you have to have permission to order more than one month's worth at a time.  It is not supposed to mean that you can only get a lesser dosage, even if your doctor prescribes more.   The thing that I don't completely understand is what happens when a company will no longer cover a drug, such as Gleevec.  You can make an appeal.  But if it is turned down, then are you still supposed to only be able to change policies in November and December of each year.  What happens when they quit covering it in January--do we have to wait to get it covered till November.   I intend to attend a Medicare workshop tomorrow and hope to get clarification on that subject.    So far the cheapest plan available in the State of Kansas, one of Humana's plans, is also the best. Margot New! Sign up for local CML support group meetings in your local community at http://cml.meetup.com Apply for Commercial Real Estate loans online and submit your deal to dozens of hungry lenders in just minutes. Loan programs for all types of business and commercial real estate. Apply anytime at http://realestatezoo.com CML (Chronic Myelogenous Leukemia Support List) --------------------------------- Part Of CMLHope.Com An International Community Of CML Patients For more information: http://cmlhope.com Post Message: cml@yahoogroups.com Subscribe:  [EMAIL PROTECTED] Unsubscribe:  [EMAIL PROTECTED] Change To No Mail/Web: [EMAIL PROTECTED] Change To Digest: [EMAIL PROTECTED] Change To Email: [EMAIL PROTECTED] List Help: [EMAIL PROTECTED]  CML Group Web Site http://groups.yahoo.com/group/CML SPONSORED LINKS Chronic myelogenous leukemia Leukemia treatment Cml YAHOO! GROUPS LINKS  Visit your group "CML" on the web.    To unsubscribe from this group, send an email to:  [EMAIL PROTECTED]    Your use of Yahoo! Groups is subject to the Yahoo! Terms of Service.