I start IVIG

[Virginia]

BBS, yes definitely on Medicare, but also have a secondary drug coverage under Medicare Part D. Although since it is under Medicare I think they pay for all infusions that are given in a hospital or fusion center. Is that correct or wrong?

[Sunshine]

Got my first EOB. Medicare sets the price and paid 80% of the infusion and the plasma drug infused. I expect BCBS Medicare supplement will pick up the 20%. My part D drug coverage was not tapped into. Maybe it's like chemo?

[Howie]

I have, had ?, Medicare, and Medicaid. My last doctor visit which has always been paid by Medicare or Medicaid wasn't paid, so it was out of pocket. I checked on it, and was told something about a "spend down". I have no idea what that is.

A few days later, I got 2 of my meds, and paid a few $ for each like it's always been. But next paycheck, I'll have 5 meds to pick up, and I don't know if I'm going to have to pay full price, or the reduced price I've always paid.

If they are full price, then I will have to stop taking them. I really don't like not knowing where I stand with Medicaid and Medicare, but I will soon find out.

[agate]

Howie, your state may have things set up so you have to spend a certain amount out of pocket for rx's before Medicaid/Medicare starts covering them. You'll want to know what that amount is, probably. It's like an insurance deductible in a way.

Here, and in WA state--and I thought in all states but maybe not--when Medicare started covering rx drugs (Medicare Part D), most people signed up for one of the insurance companies who were taking over the management of Medicare Part D.

Those on Medicaid got a long list of companies to choose from but there was also a Medicaid number to call and someone sorted through these plans to find the best one for your rx's.

The one I've had all along has a copay for rx's but because it's Medicaid, that copay isn't ever supposed to go over a certain amount per rx. Sometimes it's about $2.50, sometimes it's a few dollars more.

If a drug isn't in the formulary for covered drugs, I'd need to pay for the whole cost, I think.

If you're on one of those plans, you'd have been issued a card. Mine says AARP Medicare Complete and is from United Health Care but there are a bazillion other plans. If you call the customer service 800 number on the back of the card (and wait a long time!) you can usually find out the information you want about the payments and coverage.

[Sunshine]

Next infusion is Tuesday.

[Howie]

I went and got my other meds payday, and it was still the almost free price. So I actually read part of the Medicare book they send each year, and I found out my meds are covered by Medicare, not Medicaid. I have A,B, and D. So I'm good on the main issue which was getting my meds. The doctor I don't see again until December, and think the spend-down will be over by then. Show me the hoop, and I'll jump through it.

[Virginia]

That is good Howie, but if you have drugs under Medicare then you must be paying for B and D - only A is free. Would you not know if you were paying for B and D out of your Social Security? You could look on the SS statement that you get at each first of the year. It tells you there what is taken out. Also, D can be changed, as far as what insurance company you use every year. I start looking in October and November to see if my plan is the cheapest and best for me. First I look at my current formulary to see if Rebif and other drugs are covered and to see how much premium is going up the first of January. If I am not satisfied I then start to look at other plans offered in my area. The plans offered are listed in the book that you get every year entitled "Medicare and You".

I have not looked at the book except for myself and maybe you come under a plan that I am unaware of. If so that is real good.

[Virginia]

BBS, we will be waiting for an update. I think things will just keep looking up for you.

[SalpalSally]

Keep us posted BBS!

[Sunshine]

Went to ER after infusion:

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[Sunshine]

Update:

Today is a new day as though yesterday did not really happen :) all the side effects were gone by wake up time.

Here are the benefits a I noticed today:

I notice that my shin muscles are so much better, allowing much more comfortable extended walking! I have more energy than the past week.nits like the last week the improvement fades, I think.

For six weeks I have put off going to Wal Mart. It seemed daunting , impossible, to walk across the very hot parking lot and through the stadium size store. This morning it seemed like no big deal, so I went.

And it was almost like I didn't have MS, or maybe more like my MS was three years ago. And I went all over the store, from the supermarket part, to the vacuum section to the kids and the woman's tshirt section and then the garden section. Then I stopped at three other businesses in the heat. And later on cooked a great meal.

perhsps it was because I had a day off and didn't surf. I really don't know. But I loved it.

[agate]

Wow, sounds like a shopping spree! Enjoy!

[Virginia]

BBS, that is so great that you are able to do all that. As Agate said "enjoy".

[SalpalSally]

I used to get that wonderful feeling in the good old days.....wow for you BBS!!!