Posted by RN320 on March 28, 2007, at 17:11:22
In reply to Re: 10 months on EMSAM!!-/Dopamine, posted by stargazer on March 26, 2007, at 0:17:45
Hi SG- Sorry it took me so long to respond to you. I was in the hospital for just under a week, and just got discharged last evening.
My(Medicare Part D)carrier covered EMSAM from June through December, but I dropped Humana because their customer service was horrible in my opinion, and they had increased their monthly rates to the point that Humana was now the highest Medicare Part D drug premium in Michigan, and had changed their benefits to the point that it really didn't matter if you had to take a brand name drug or not. Once you got into the "gap" phase, Humana had offered great incentives that had recuited most of us suckers to take the plan: and that all a recipient would have to pay during once the gap hit was the exact co-pays on brand names, etc. Then they quit doing it- totally slashed the whole program in 2007, yet you might notice that Humana's premiums they (yet again) some of the most costly. The company I chose is not far behind from Humana in cost from what I paid Humana in 2006! The company is EnvisionRx.com and as long as you get your fills and refills from COSTCO, they have a wonderful thing from day #1: Generics are free, ALL YEAR LONG(doesn't matter where you are in the gap).if you get your scripts filled and refilled at COSTCO, they are free!!! I'm on over 20 meds a day and I just couldn't say no to this company. But the wonderful part of this is that yes, your generics continue to have 0$ copays the remainder of the plan year!! And no, they don't cover EMSAM at all. I knew that I'd have a train wreck coming my way come January 1 of 2007 regarding this situation. Samples are hard to come by for pdocs. Samples only come in 6mg doses.
When I went on to try and meet the people from ENvision Rx's Insurance Prescription Board, I was told that I'd need to contact them all individually, via phone or email. Everyone I spoke with was very pleasant. They told me that it was Non-Formunlary for their company, and that if i tried to get an exception through that I'd for sure fail, since as far as they're all concerned, EMSAM is just a "designer drug" and there are "many alternative MAOI's out there". So my pdoc said there was no sense in trying to pull off the overturning of an appeal from them with this kind of mindset.So, back in November I contacted BMS (Bristol-Myers, Squibb) and I talked to them about thier patient assistance foudation. I was very sad and started to get tearful because it felt that the people who were supposed to help people like me, aren't really helping me at all, nor did they plan to.
So, in December, a dear friend of mine out on the West Coast, who had been a pharmacy drug rep for many years and who hasn't been in the industry for 20 years now (ever since the day her first child was born). I was just about jumping off the roof when Nancy said that she really felt she could help me- told me that she'd take up where I left off and manage the whole process from now on. She said that from that point off, that I should just concentrate and have a nice Christmas- that she'd manage everything. She'd get a form, and if it was something she could do or do in follow up to it, she'd do it for me. She'd fax me the different questionaires and I'd fill them out and fax them to her. She'd send other things she found out about the drug as we went along. Their (BMS's) requests were about 300% more that they stated. It was a nightmare for me even when the pressure was supposed to be off. In the end, just 2 weeks ago I received my 1st 3 weeks of EMSAM. I'll get 3 more every 2-3 months for a year, but at least I now know what I have to supply to them and won't be a shocked as prevously.
Good Luck to all of you in finding financial support for this drug if you have no insurance or source of financial assistance.
/RN320
poster:RN320
thread:739754
URL: http://www.dr-bob.org/babble/20070327/msgs/745039.html