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Insurance Coverage
So I will do my best to make this short. So my boyfriend was on Tecfidera and his Insurance switched him to the generic version Dimethyl Fumarate. When he went to the pharmacy to fill it they wanted him to pay $4000 a month. Spent a ton of time of time on the phone with the pharmacy, insurance and Biogen (maker’s of Tecfidera). Biogen said they would help pay for Vumerity if the insurance company would also help. Of course, the insurance company said won’t and Biogen can only help so much. We talked to insurance again and they said he should have a $30 co-pay on the Dimethyl Fumarate and that they would straighten it out with the pharmacy. Well they called us back today and now are saying they want $1300 a month. We can’t afford that, we are struggling as is. He is still working but makes too much to qualify for any financial assistance programs (we are right on the edge-of course) and he is not old enough to qualify for Medicare or Medicaid (He’s 50). We are stuck and he is out of medication. Any advice regarding which insurance companies will cover MS medication? Extra note: he will not do injections so those medications are pretty much out.
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