HELPING YOU PUT TOGETHER YOUR MEDICARE PUZZLE
MBG IS AN INSURANCE BROKER AND IS NOT ASSOCIATED, ENDORSED, OR AUTHORIZED BY THE SOCIAL SECURITY ADMINISTRATION, THE DEPARTMENT OF HEALTH AND HUMAN SERVICES, OR THE CENTER FOR MEDICARE AND MEDICAID SERVICES (CMS)
Ocrevus has become a pivotal medication in the battle against multiple sclerosis (MS), particularly in its progressive forms. But as with many cutting-edge treatments, the cost can be daunting. In this blog post, we’ll dive into how Medicare helps bridge the gap between medical need and affordability for this breakthrough drug.
What is Ocrevus? 💊
Ocrevus (ocrelizumab) is an intravenous medication that has shown promise in treating both relapsing and progressive forms of MS. It works by targeting and depleting specific B cells, which are believed to play a role in the abnormal immune response in MS.
Cost Implications 💵
The financial burden of Ocrevus can be significant. A single infusion can cost upwards of $30,000, making Medicare’s role pivotal for those needing this medication.
Ocrevus and Medicare 📘
Most commonly, Ocrevus is covered under Medicare Part B, as it is administered in a healthcare setting, like a hospital outpatient department or a doctor’s office.
Coverage Details 📊
Under Medicare Part B, you usually pay 20% of the Medicare-approved amount for the drug, and the Part B deductible applies. The cost can still be substantial but is generally more manageable than paying entirely out-of-pocket.
Prior Authorization and Limitations ⚠️
Medicare may require “prior authorization” for Ocrevus, which means that your healthcare provider must confirm the drug is medically necessary for your condition.
Extra Coverage 🛡️
If you find that the 20% coinsurance under Medicare Part B is still burdensome, you might consider a Medigap policy to help cover these additional costs.
Ocrevus stands as a landmark achievement in MS treatment, providing hope for those dealing with this often debilitating condition. While the medication is pricey, Medicare—particularly Part B—does offer some relief by covering a portion of the costs.
The symbiosis between Ocrevus and Medicare highlights the vital role of healthcare coverage in ensuring that innovative, life-altering treatments can reach the people who need them most. 🌟
MBG IS AN INSURANCE BROKER AND IS NOT ASSOCIATED, ENDORSED, OR AUTHORIZED BY THE SOCIAL SECURITY ADMINISTRATION, THE DEPARTMENT OF HEALTH AND HUMAN SERVICES, OR THE CENTER FOR MEDICARE AND MEDICAID