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Medical Forum / Diseases and Disorders / Breast Cancer / September 2004

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Medicare Recieptants

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Guess Who - 25 Sep 2004 02:12 GMT
I have attended several conferences this past week regarding pharmacy costs. Both state that there are plenty of open spots

Deadline for Medicare drug demo project is Sept. 30

WASHINGTON, D.C. - Sept. 17, 2004 - Cancer patients will need to hurry to meet a Sept. 30 deadline to sign up for a Medicare demonstration project that will pay a portion of the cost of certain oral cancer drugs.

The project will involve up to 25,000 cancer patients who will receive the oral anti-cancer drugs between now and when the new Medicare prescription drug coverage begins in January 2006.

Under the demonstration, as established under the Medicare Modernization Act (MMA), Medicare will pay for certain drugs and biologicals that can be taken by the patient at home. Because these drugs will be included in the new Medicare drug benefit in 2006, the demonstration study provides an opportunity for Medicare to learn about the impact of the new drug coverage on the use of oral drugs that can "replace" currently covered Part B drugs.

The cancer drug project will enroll randomly selected Medicare beneficiaries with no other drug coverage who meet the eligibility requirements. The patient's doctor needs to certify the patient needs one of the oral drugs from a specified list to treat certain cancer types and stages.

A percentage (estimated at 10%) of people were selected from those who applied between July 6 and Aug. 16. Those patients began coverage Sept. 1. All people not selected in the first application round will be automatically carried over into the second round of applications.

The remaining participants will be selected from the second application round, which began July 6 and will close Sept. 30 . Those selected from that round will begin coverage on Oct. 18.

The specific cancer drugs covered under the cancer drug project include:

 a.. Tamoxifen (NolvadexT) - for stages 2-4 breast cancer

 b.. Imatinib mesylate (GleevecT) - for chronic myelogenous leukemia and gastrointestinal stromal tumor

 c.. Gefitinib (IressaT) - for non-small cell lung cancer

 d.. Anastrozole (ArimidexT) - for stages 2-4 breast cancer

 e.. Letrozole (FemaraT) - for stages 2-4 breast cancer

 f.. Bexarotene (TargretinT) - for cutaneous T-cell lymphoma

 g.. Thalidomide (ThalomidT) - for multiple myeloma

 h.. Altretamine (HexalenT) - for epithelial ovarian cancer

 i.. Exemestane (AromasinT) - for stages 2-4 breast cancer

 j.. Toremifene (FarestonT) - for stages 2-4 breast cancer

 k.. Mesna (MesnexT) - for people receiving ifosfamide

Eligible patients must be covered by Medicare Part A and B, or will have Medicare Part A and B in October 2004 and must list Medicare as their primary payer. Patients also must live in the 50 states or District of Columbia and must not have other comprehensive drug coverage.

To apply fill out an application form; and submit it with a form filled out by your doctor certifying your need for one or more of the drugs on the covered list for specific cancer indications.

Both forms are available online at the Centers for Medicare & Medicaid Services (CMS) Web site, or by calling 1-866-563-5386, Mon.-Fri., 8AM-7:30PM (EST)
Kathleen Langwell - 25 Sep 2004 03:35 GMT
I saw a post re: this posted here last June or early July and called and
got the forms and got picked in the first lottery drawing and started
the Arimidex Sept. 1. My only income is from SS Disability so I filled
out the financial info part too. There are several levels of benefits
depending on your circumstances, and if it were not for this program I
would not be able to afford Arimidex. Even ordering from Canada would
have been too much for me. I am so thankful I hurried and followed
through when this info was posted last summer.

Because of my income and very low assets I'm paying practically nothing
for the Arimidex. Sometimes good things do happen. Yes, you must have
Medicare parts A and B, and be able to verify the information (if asked)
if you apply for financial benefits, but this program was a lifeline for
me. I just hope the govt. doesn't rescind it. It is a pre-cursor to the
Medicare Part D program that will start in Jan 2006. Unfortunately,
there isn't much time left--your doc. must fill out the medical part.

Kathie
Guess Who - 25 Sep 2004 03:49 GMT
Glad to hear you are one of the few who got the benefit, I heard the paper
work was difficult. I Think this is a test program, so if you like the
program make sure your congressman and senator know your feelings.
Kathleen Langwell - 25 Sep 2004 20:18 GMT
Yes, this Medicare Replacement Drug Demo program does seem to be a test.
I think they're trying to see how many will use the new oral drugs and
stay on them. Maybe there will be follow-up questionnaires in Dec. 2005.

The paperwork wasn't hard, just many pages. I submitted every page even
if it just called for a signature that you had read it. They had a tele.
# you could call with any questions. I thought all the info in the
package they sent was very thorough. I don't know how many applied, but
above posts says there are still open spots. I'm very curious to know
what bc drugs Medicare is dropping in favor of newer oral drugs. Only
hormonal drugs offered for bc. in this program--they weren't covered
before. I think that's what this is about.

Kathie
Guess Who - 26 Sep 2004 03:13 GMT
I was told at the last conference that only 4000 applications were completed

> Yes, this Medicare Replacement Drug Demo program does seem to be a test.
> I think they're trying to see how many will use the new oral drugs and
[quoted text clipped - 10 lines]
>
> Kathie
Kathleen Langwell - 26 Sep 2004 19:00 GMT
>I was told at the last conference that only
> 4000 applications were completed

That's a shame. I don't think enough people knew about it, or perhaps
not so many patients had Medicare Parts A and B. There were also drugs
offered for people with other life-threatening diseases besides
cancer--in fact, more non-cancer patients were eligible. At any rate,
I'm getting Arimidex, which would have cost $250/mo. for $5/mo. so I am
very grateful to the original poster (I think it was J.), and so glad I
called CMS and got all the forms and info.

It pays to be pro-active.

Kathie-
Guess Who - 27 Sep 2004 22:34 GMT
Believe it or not Medicare did the initial posting, J just re posted there
post. Sometimes Medicare does things right.
http://tinyurl.com/5g3nt
The important thing you got the coverage.
Signature


> >I was told at the last conference that only
>> 4000 applications were completed
[quoted text clipped - 10 lines]
>
> Kathie-
J - 28 Sep 2004 01:43 GMT
> Believe it or not Medicare did the initial posting, J just re posted there
> post.

I did not repost Medicare's post ! You make a claim, you prove it. Otherwise
quit lying about me.

I posted these to alt.support.cancer about Arimidex
http://tinyurl.com/4acrn
The first one was crossposted here. (July 3/04)
J
Guess Who - 28 Sep 2004 04:14 GMT
I simply stated Medicare was the first one to get the information out, they
are often maligned for not doing the write thing, I don't believe I called
you a liar and don't appreciate your hostility. You are the champion of
reposting, crossposting, and hyperlinking... You are correct you reposted
from another website, www.cancer.org
and did not abide to their user agreement- unless you got their written
agreement.

"Unless otherwise indicated, all information contained on this web site,
such as text, graphics, logos, button icons, images, audio clips is
copyrighted by and proprietary to the American Cancer Society, Inc., and may
not be copied, reproduced, transmitted, displayed, performed, distributed,
sublicensed, altered, stored for subsequent use or otherwise used in whole
or in part in any manner without ACS' prior written consent, except that the
user may make such temporary copies in a single computer's RAM and hard
drive cache as are necessary to browse the website."
http://www.cancer.org/docroot/SU/content/SU_1_1_User_Agreement.asp?sitearea=SU

>> Believe it or not Medicare did the initial posting, J just re posted
>> there
[quoted text clipped - 8 lines]
> The first one was crossposted here. (July 3/04)
> J
J - 28 Sep 2004 02:43 GMT
> >I was told at the last conference that only
> > 4000 applications were completed
[quoted text clipped - 10 lines]
>
> Kathie-

My apologies (to the group) for losing my temper with Guess Who.
I really don't care which post you read, mine or Medicare's,
I'm just happy to read that you've obtained assistance with the treatment.
Best wishes and hugs, Kathie
J
 
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