The MS Wire

News, info and tips for living with multiple sclerosis

Category: Insurance

Will the Third Time be the Charm for Amazon Healthcare?

amazon healthcare

For the past few years, the company that brings us everything from books to basketballs has been experimenting with bringing us Amazon healthcare. In 2018, the company launched a project called Haven in partnership with a pair of financial giants, with the goal of providing healthcare services to over a million employees. The idea behind the project was “to make primary care easier to access, insurance benefits simpler to understand…Continue Reading

A Health Insurance Change Makes me Feel like Alice in Wonderland

health insurance madness

For my wife, Laura, and I, trying to change our address on our health insurance accounts last week was like following Alice down the rabbit hole. “The rabbit-hole went straight on like a tunnel for some way, and then dipped suddenly down, so suddenly that Alice had not a moment to think about stopping herself before she found herself falling down a very deep well.“ Lewis Carroll – “Alice’s Adventures…Continue Reading

Big Insurance Sues Big Pharma Over Copay Funding

copay lawsuit

People living with multiple sclerosis know that the medications used to treat it are expensive. According to the National Multiple Sclerosis Society, the median annual price of brand-name disease-modifying therapies (DMTs) last year was $91,835. Five of them carried a price tag of more than $100,000 a year. Many pharmaceutical companies help defray the out-of-pocket costs of their DMTs for patients. But U.S. law strictly limits how this can be…Continue Reading

Judge Calls Health Insurance Denial “Immoral and Barbaric”

Judge

Robert Scola Jr. is a federal judge in Miami and he’s just recused himself from a case involving the UnitedHealthcare (UHC) insurance company. The case is one of two filed in Miami over the last two months claiming that UHC has improperly denied coverage for a specific cancer treatment. Scola calls that denial “immoral and barbaric.” He put those words on paper in his recusal order. In his order, Scola…Continue Reading

Insurer Sends Patients to Mexico to Find Less Expensive Meds

Less expensive meds

MS medications are expensive in the United States. We all know that. We also know that less expensive meds can be found in places like Canada and Mexico. So, here’s a novel idea from the nonprofit health insurance provider PEHP, which covers state workers and their families in Utah: Pay those patients to buy their expensive meds south of the border. As Erin Alberty reports in The Salt Lake Tribune, the…Continue Reading

Serious Medications Need Serious Care Coordination

Ocrevus (ocrelizumab) is a serious disease-modifying therapy. It has the potential to deliver a major blow to a patient’s multiple sclerosis, but it also carries the possibility of severe side effects. The protocol for Ocrevus requires different doses on different infusion dates, following a specific treatment schedule. It’s also very expensive. This all shouts for the need for serious care coordination! Jamie’s care coordination problems I was concerned when Jamie, who…Continue Reading

Medical Bills and My EOB: Trust, but Verify

“Trust, but verify” was a key concept during the U.S.-Soviet nuclear negotiations of the 1980s. “Trust,” President Ronald Reagan would say, “but verify” that what’s being said is actually being done. I apply that same concept to my bank, trusting that it has all of my checking account information correct, but also verifying their records against mine every month. I do the same with my credit card bills, and just…Continue Reading

MS Patients Get Caught on an Insurance Deductible Snag

MS drugs are expensive. Many people with MS are able to afford their high prices only because their insurance covers most of the cost. Then what remains as a copay has often been covered by the pharmaceutical companies that produce those meds, who have offered patient assistance programs or discount cards to help pay the copay. So, your out-of-pocket costs have been minimal or none. Now, however, that paradigm is…Continue Reading

It Shouldn’t be This Hard to Get Our MS Medications

I got a phone call from my MS One to One nurse, Lynn, a few days ago. One to One is the patient support service provided by Sanofi Genzyme for patients on the biotech company’s MS disease-modifying therapies (DMTs) Lemtrada (alemtuzumab) and Aubagio (teriflunomide). Lynn called to ensure that all of the paperwork was up-to-date and ready for my second round of Lemtrada infusions, which is scheduled to begin the…Continue Reading