6 ms·

I have MS and receive an Ocrevus infusion every six months. It's a labyrinth of a process. UHC (insurer) sub-contracts(?) to CVS Caremark to provide specialty d

I have MS and receive an Ocrevus infusion every six months. It's a labyrinth of a process. UHC (insurer) sub-contracts(?) to CVS Caremark to provide specialty drugs. CVS insists on calling me to confirm they can ship it to my house. F no! I'm not running an IV for myself. Sort it out with the hospital. Last go around, the hospital coded the drug as coming from their supply instead of CVS so I got a surprise bill for $130,000+ Luckily, I've been through the process so there's records of the normal billing path. I fought the Hospital billing department and 5 months later I'm billed $700 which was about the expected amount. It was still stressful and time consuming to figure out if I screwed up to the tune of 6 figures.

giantg2 2y ago
For $700, I'll start my own IV.
- droopyEyelids 2y ago
  Infusion medicine isn't given in the normal gravity-fed IV route, they're precisely controlled for flow rate and time. It's a whole other ball game.
  - giantg2 2y ago
    The machines take care of that. You just need to plug the numbers in.
dools 2y ago
Greetings from Australia. My brother has MS and gets a monthly infusion of Tysabri. All he does is show his Medicare card and it doesn't cost him anything.
- didacticBuffalo 2y ago
  I looked at leaving the US years ago. Australia was on my short list after spending some time in Melbourne. Alas MS is one of those things that makes immigration harder nearly everywhere because it "puts an undue burden on the health system". Never found a way around that aside from maybe marrying a local; it's been a while. Glad he's getting the treatment he needs!! Drugs have made incredible advances in the last decade.
  - dools 2y ago
    Yeah that's a bummer :( And yes drugs have made incredible advances -- my aunt (and hence my brother's aunt) had MS and her life was ruined by it. Pretty amazing to see something advance that quickly with such a stark difference in outcomes between 2 of my own family members. When my brother told me it was relatively benign given they caught it early and he had access to treatment I was like "I read 10 books for the MS Readathon in Year 1... You're welcome!"
- beachy 2y ago
  My brother lives over the ditch in Australia. He developed very serious metastasised melanoma. He was prescribed a very new drug which has worked brilliantly and saved his life. The first time he left the pharmacy with his monthly prescription, the pharmacist told him to take care, because the pills he'd given him cost more than $20k. For a months supply. The cost to him - absolutely nothing.
  - MadnessASAP 2y ago
    I had to pay for parking once at a hospital in Canada, I thought that was outrageous and parked down the street at free parking in protest.
DeRock 2y ago
> CVS insists on calling me to confirm they can ship it to my house. F no! You joke, but this is what my wife does for her infusion. Drugs get shipped to our house, and nurse comes to the house to administer the infusion. She gets to spend the time on the couch watching TV instead of in a hospital. And as a another indictment to the broken health care system, this is actually cheaper to the insurer!
WBrentWilliams 2y ago
My sympathies and commiseration. I am on a different infused medication and survived a couple of years of CVS Caremark acting as a Pharmacy Benefits Manager for "specialty drugs" before my insurance and the hospital system I work with negotiated a different delivery and fee structure. Not before, of course, my own higher-than-expected bill. I am on an HDHP and arrange my finances and budget with the expectation that I will reach my out-of-pocket maximum. I am thankful that I am in a position to do that. The backside being that I am under enormous constraint in terms of my employer. They literally own my health, as while I am skilled and valued, I doubt that I am skilled and valued enough for another employer to keep me after poaching me away. I would expect something in the off-the-record review comments of "...health care costs are how much!?!?" followed by quiet PIP-and-dismissal or dismissal outright under the laws of my state-of-residence in the United States. Yes, I live in a right-to-work state, meaning that my employment can be terminated at any time, by either party, for any reason, or no reason given at all.
- operationlllll 2y ago
  [dead]

giantg2 2y ago

For $700, I'll start my own IV.

droopyEyelids 2y ago
Infusion medicine isn't given in the normal gravity-fed IV route, they're precisely controlled for flow rate and time. It's a whole other ball game.
- giantg2 2y ago
  The machines take care of that. You just need to plug the numbers in.

dools 2y ago

Greetings from Australia. My brother has MS and gets a monthly infusion of Tysabri. All he does is show his Medicare card and it doesn't cost him anything.

didacticBuffalo 2y ago
I looked at leaving the US years ago. Australia was on my short list after spending some time in Melbourne. Alas MS is one of those things that makes immigration harder nearly everywhere because it "puts an undue burden on the health system". Never found a way around that aside from maybe marrying a local; it's been a while. Glad he's getting the treatment he needs!! Drugs have made incredible advances in the last decade.
- dools 2y ago
  Yeah that's a bummer :( And yes drugs have made incredible advances -- my aunt (and hence my brother's aunt) had MS and her life was ruined by it. Pretty amazing to see something advance that quickly with such a stark difference in outcomes between 2 of my own family members. When my brother told me it was relatively benign given they caught it early and he had access to treatment I was like "I read 10 books for the MS Readathon in Year 1... You're welcome!"
beachy 2y ago
My brother lives over the ditch in Australia. He developed very serious metastasised melanoma. He was prescribed a very new drug which has worked brilliantly and saved his life. The first time he left the pharmacy with his monthly prescription, the pharmacist told him to take care, because the pills he'd given him cost more than $20k. For a months supply. The cost to him - absolutely nothing.
- MadnessASAP 2y ago
  I had to pay for parking once at a hospital in Canada, I thought that was outrageous and parked down the street at free parking in protest.

DeRock 2y ago

> CVS insists on calling me to confirm they can ship it to my house. F no! You joke, but this is what my wife does for her infusion. Drugs get shipped to our house, and nurse comes to the house to administer the infusion. She gets to spend the time on the couch watching TV instead of in a hospital. And as a another indictment to the broken health care system, this is actually cheaper to the insurer!

WBrentWilliams 2y ago

My sympathies and commiseration. I am on a different infused medication and survived a couple of years of CVS Caremark acting as a Pharmacy Benefits Manager for "specialty drugs" before my insurance and the hospital system I work with negotiated a different delivery and fee structure. Not before, of course, my own higher-than-expected bill. I am on an HDHP and arrange my finances and budget with the expectation that I will reach my out-of-pocket maximum. I am thankful that I am in a position to do that. The backside being that I am under enormous constraint in terms of my employer. They literally own my health, as while I am skilled and valued, I doubt that I am skilled and valued enough for another employer to keep me after poaching me away. I would expect something in the off-the-record review comments of "...health care costs are how much!?!?" followed by quiet PIP-and-dismissal or dismissal outright under the laws of my state-of-residence in the United States. Yes, I live in a right-to-work state, meaning that my employment can be terminated at any time, by either party, for any reason, or no reason given at all.

operationlllll 2y ago
[dead]