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How to work around Medicare supplemental insurance coverage for medical treatments

I have been diagnosed with severe asthma, my asthma doctor put me on a three month trial program with dupixent injections the injections were from samples given to the doctor. Dupixent did wonders for my asthma. Medicare part A and B along with my supplemental insurance were going to pay all but one thousand a month due my husband's 2022 tax return the high income is from him. Since the dupixent they have tried fasenra, nucala and now I'm on tedspire two of the injections worked OK but then tapered off. I'd like to go back on dupixent but am unable to afford it with my personal income. Does anyone know how to work around this dilemma

  1. Hi. Thank you for sharing your asthma story and for your question. It will be neat hearing what ideas other community members have to share about your question. In the meantime, I have one idea for you. One thing that has worked for me in the past, when my insurance did not want to pay for a medicine that I felt was very helpful for me, was to have my doctor write a letter to my insurance company explaining why this medicine benefits me. Is this something you would be willing to try? John. community moderator.

    1. Hi , and thanks for your post and question - it's a good one! I see my colleague, , has provided you with one suggestion from his vast experience. Like, John, I have done something similar when necessary and, have been successful, too!
      I have something additional to contribute. Like you, I am on Medicare now, too. Medicare is my primary insurance, while my wife's insurance coverage (family plan), is used for secondary coverage. We are both retired and are fortunate to have the secondary health insurance based on her previous employment.
      I have found, that between both Medicare and the secondary insurance, our pharmaceutical needs are, for the most part, covered with the exception of copays, which are our responsibility.
      The copay varies, depending on the type of medication we need. Some are rather expensive (for specialty medications), but, we pay them since we need the medication.
      Is this something that might work in your case? Are you finding that other medications have become cost prohibitive, even with the insurance coverage?
      Wishing you well,
      Leon (site moderator

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