4/14/09

Tysabri Insurance

If you're lucky like me, you get your Tysabri (or other medicine) paid for In Full-! I'm sorry, folks, I didn't do anything special to get to this point. I got on SSDI after the typical 2-year wait & because Tysabri is an infusion, it falls under Part B of Medicare. Overall Better coverage than Part D(pill-type medicine). And why Just Me--? Everyone who is disabled & on medicine should be getting medicine for Free, or a minimal co-pay, depending on their Insurance. So who should Pay, You Ask? Whoever has been playing the game of Making Huge Profits from this Medical System.
WE -- You & Me = The Common Man, The Little Guy, etc. has No Say in what's going on. What makes me say this--well, here's the story, no I mean the Facts: my latest EOB (Explanation of Benefits) shows that the hospital where I get my monthly infusions of Tysabri charged Medicare $9,726 (the most ever); Medicare Paid $9,223 and my supplemental paid $503. Because everyone has to cover expenses & try to "stay in the Black", everyone OVERCHARGES for services, medicines, etc. One thing leads to another & the ball keeps rolling. So Medicare is paying the "Fake" price of $9,223 for me to get Tysabri EVERY MONTH-? How ridiculous is this & how long will it go on-? I'm overwhelmed & don't have anything else to say at this time. P.S. I hope everyone had a nice Easter.

4 comments:

LISA EMRICH said...

That's unbelievable. Wow. At least $6000 too much. Unbelievable.

mzzm said...

My wife is on Tysabri and our insurance is charged around $5000 per each monthly injection. The insurance company then pays them an agreed amount of around $2500. We do end up with an out of pocket amount each year which can get out of hand because we have BCBS PPO, yet it is better than paying the $5000. I'm not sure how the Tysabri clinic in Phoenix is able to charge so much?

Stuart said...

deej
Please contact stuart at: stuartschlossman@bellsouth.net - thank you

Anonymous said...

I've received Tysabri infusions at two different infusion centers. The fancy infusion center in Plymouth, MN, charged around $4,300for the infusions. The tiny little chemo. department at the regional hospital in Marshall charges over $7,500.