enbrel and insurance

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E.V. - 07 Jan 2005 11:24 GMT

Hi everybody,

I just learned that my insurance will no longer cover my enbrel. I
have an Aetna medicare HMO threw my job's retiree plan. Their
explanation is "Medicare stopped covering it, so we're stopping
covering it."

-I'm completely freaked. Enbrel has kept me going for the past seven
years and after this month's supply is gone, that's it.

Has anyone had a similar experience with their insurer? I'm not really
sure what to do next. EV

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Nann Bell - 07 Jan 2005 13:49 GMT

It seems to me that Medicare wouldn't have covered Enbrel anyway as it is a
self-administered medication, though I could be wrong. You might try calling
the Enbrel number 1-888-4ENBREL (1-888-436-2735) and see what they have to
say and if they can help you.

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Mary Z - 07 Jan 2005 14:11 GMT

>Has anyone had a similar experience with their insurer? I'm not really
>sure what to do next. EV

Remicade is covered by medicare and often is much more expensive than
Enbrel see if the potential switch will buy you some leverage. If not
you might have to switch to Remicade. -- MZ

Visit my website:
http://www.mzuschlag.com

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Thumper - 07 Jan 2005 17:13 GMT

>>Has anyone had a similar experience with their insurer? I'm not really
>>sure what to do next. EV
>
>Remicade is covered by medicare and often is much more expensive than
>Enbrel see if the potential switch will buy you some leverage. If not
>you might have to switch to Remicade. -- MZ

Are you sure medicare doesn't cover it?
Thumper

>Visit my website:
>http://www.mzuschlag.com

To reply drop XYZ in address

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Mary Z - 08 Jan 2005 00:48 GMT

>Are you sure medicare doesn't cover it?

Good point I just checked an there is a pilot program that is supposed
to pay part of the cost. Not sure what the specifics are but you
should call Enbrel it would give you amo against your insurance
company. Keep fighting don't give up! It is amazing what happens when
you do not give up insurance companies expect people accept their
decisions. -- MZ

Visit my website:
http://www.mzuschlag.com

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Mercedes - 07 Jan 2005 18:07 GMT

If ENBREL cannot help I would call your doctor and see if you can get
information about drug assistance programs in your area or maybe nationally.
There are plenty of programs out there, just have to see which ones will
help.

Shandi

> Hi everybody,
>
[quoted text clipped - 8 lines]
> Has anyone had a similar experience with their insurer? I'm not really
> sure what to do next. EV

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firechief - 08 Jan 2005 02:19 GMT

> Has anyone had a similar experience with their insurer?
> I'm not really sure what to do next. EV

In what state do you live? Answers can vary from location
to location.

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