(Guest Lecture): January 2024 - How Do You Afford Your Cancer Drugs? Uncovering Patient Assistance Programs That Can Help

Diana Valentine, BCPA. She's our financial program manager for the Health Treat Foundation. And she specializes in financial health for blood cancer patients. She is a professional financial advisor and also the former caregiver of her husband who was diagnosed with multiple myeloma. Diana perfectly understands the financial issues facing cancer patients and more than perfectly understands she has this deep desire and passion to be able to help people who are in the same situation that she found herself in. So with that being said, Diana, I'll turn the time over to you for the latest financial updates. Hello, happy new year to everyone. It's really good, like as Audrey said, to get back into the thick of everything. We're getting closer and closer to those, so those changes is gonna be going in Medicare with the reduction or the cap on your out-of-pocket expenses. And I want you guys to keep up with what's going on with Medicare. There are some fights to try to change some of those things. A big Medicare Advantage again is a big sticking point for a lot of people, a lot of financial, a lot of healthcare providers are dropping at a great rate, a fast rate Medicare Advantage plans. You don't know until you go in. In fact, there are people who've gotten notices saying their insurance was gonna be kept through the end of this past December, but yet their insurance provider was not honoring that statement. So please keep up on that. Another thing a lot of people have been asking about, out-of-pocket cost or financial help for linoleumide, Mageson.org is a pharmaceutical company and they're helping for the out-of-pocket cost for linoleumide, the biosimilar for Revlimid. So I have that, I have set out on our connect page on the financial connection information regarding that. Please look on that. In addition, keep up with, as a new year, some of these nonprofits or organizations like LLS and HealthWell who still has funds available for Medicare access, other organizations are gonna be coming up with funds. Keep an eye out on that. Some of them have not opened yet, but they will, probably will start opening up here in the next few weeks. They don't stay open for long sometimes. Other times they stay open longer than we anticipate, but keep an eye on that. You don't wanna miss those things because this past year was very, very scarce starting, I guess, June or possibly the earlier April or May for some of those financial assistance programs. Again, I've had people still asking about Bristol-Meyer Squib regarding their copay assistance for Medicare recipients for the Revlimid. You have to ask for the Medicare assistance program if you just call in the regular number, they're gonna say, no, we don't offer it. Well, they don't offer it through that program. They offer it through the Medicare program. So you have to say, I'm on Medicare. I know you have a financial assistance program for Medicare recipients. So you need to ask for that to get into the application for the Revlimid patient assistance program. So that's what I want you guys to keep up on and start getting your tax forms ready. Start preparing all of the things you need in order to get your 7%, above your 7%, anything above 7% of your gross tax that you can file and file on your tax returns. Start getting those things ready. If you need any assistance, again, reach out to any of the financial coaches. We have an extended list now. We have 13 versus four people. So we should be able to answer all the questions that you have. Look forward to talking to you guys on an individual basis that you need any help. So let's get started on our webinar. So how do you afford your cancer drugs? This is a big question all year long for a lot of our patients. And we're gonna uncover patient assistance programs that can help. And I put here for drugs, but we have an extensive resource list on our Health Tree Coach financial resource page, not just for drugs, but for travel back and forth for assistance, urgent care needs, all kinds of financial assistance needs that we have on our website, as well as other websites we're gonna go through that you're gonna see on the webinar today. I think this is very important. We need to keep up with this all year long. So what we're gonna review are, we're gonna determine how to determine the cost of your drugs as soon as possible, know what drugs you're on now, or you anticipate being on for the rest of the year. What is your insurance going to pay? Very huge, because if your insurance doesn't go pay anything, you can't wait till the last minute to make sure you have things in place. Are there any generics available? That is something you need to ask your provider, but we're gonna go into that. Where do you find assistance? Keep notes on everything. If you talk to your insurance company, they say they're gonna honor that, or if you had to get pre-authorizations and they honored that, and all of a sudden you're gonna get kickback, which happened to me this past week on a medication, make sure you understand and you get questions for everything and keep notes. How does it affect your deductibles and taxes? And what information do you need to provide in order to get this financial assistance, both through your nonprofits and as well as through your pharmaceutical assistance programs? How often can you get assistance? And if you have Medicare, can you still get assistance on these programs? So we're gonna run through those things. This is probably gonna be a fairly quick webinar, but I encourage you all to ask questions at the end. No question is dumb to ask, okay? Okay, so what prescriptions will we be taking? You can check online the approximate costs. Remember the cost can vary between drug stores as well as the locations that you're in. You can go for one CVS and get a itemized cost on what that drug's gonna be, and it may be a CVS two miles down where the cost is gonna be different. So I would encourage you before you go in if you don't have full coverage for everything that's being paid for through your insurance, find out if there's any other things you can do to assist you, such as prescription cards. These are not insurance cards, they're prescription cards. There's Needy Meds, RX, WellRx, GoodRx, there's all these drugs cards. We have them online at our financial resources through HealthTreat. Look at those cards, but I want to notify you that if you were to use your card or find out what the cost is, get online and check them online for each card to say how much they're gonna tell you how much is gonna be in that particular area for particular drug stores. And like I said, the cost can vary significantly between drug store cost locations. But when you're gonna use that, you need to present that card to the pharmacist prior to them running your insurance. So present that card to them and say, how much is it gonna cost if I use this card? They can run it and say, this is how much it's gonna cost. But then if it's too much for you, then you think it's gonna be less on your insurance, then do your insurance secondary. If you do your insurance first, it's automatically gonna go through. You can't go back and do the Needy Meds or the RX or whatever cards you have. Next slide. So what is your insurance going to cover? Huge, you need to find out what your insurance is gonna cover for copays, deductibles for your RX card, whether it's your Medicare Part D or whatever you're gonna have. The most important thing you can do is to make sure you have the best coverage you can afford. Now we've already gone through Medicare Advantage Open Enrollment, we've already gone through Marketplace. Right now we are in just a general enrollment for Medicare who goes through I think March 30th. So you need to understand your prescription coverage. You need to understand what the laws have changed for prescription coverage and catastrophic coverage for medications. If you're on Medicare, understand the new costs associated with coverage as well as deductible limits and out of pocket max. You can go to the website cms.org to get information on that. Get things that are writing from insurance carriers. If you spoke to them and they said, yes, we're gonna pay that, yes, it's pre-authorization or no, you don't need pre-authorization. Have them send out a copy of that discussion because it's gonna have the promises to pay, your responsibilities, keep your records, note the person, date, time, who you spoke to. Because if you need to go back and appeal something, if you came back later on or you're denied coverage, that is going to be a really good foundation to have that overturned. So don't pay bills without an item, don't pay any of your medical bills without itemized bills to compare the ELB evidence of benefits to make sure you are being billed correctly. If not, challenge that bill. If you need help finding out how to challenge a bill or challenge a denial for a prescription or anything, we have some of that information online and I've done the webinar on those as well. Next slide. Are there any generic biosimilars available? This should be one of the first questions you ask your healthcare provider because biosimilars are supposed to have the same concoction or chemicals that the other drugs have or however they make them up. And they're supposed to have the testing done to say it's gonna have the same results. Although they are less expensive because they're not the brand or the first company who manufactured or created that drug. So if there are any biosimilars, you might wanna find out if you can use that in place of the brand, the cost is gonna be less expensive. See if you can get prescription in a different form if it's cheaper and it will not, of course, make sure it doesn't affect your care. Make sure that it's readily available. When the linoleumide, your biosimilar for your Revlimid came out, there was a shortage in it when people started, a lot of doctors were automatically putting people on the biosimilar versus the brand. Some people had, and this happens with any drugs, some people may have some contraindications or side effects to a different drug. If you don't like the biosimilar or if it's not working for you, let your doctor know. A lot of times they can get a authorization to go back to the brand name. So make sure you do that. Make sure you cover your bases. Make sure you have options for your prescriptions if that is available to you, especially when cost is a prohibitive factor. Next slide. So where can you find financial assistance for medications? There are quite a few places. One of the first things that you're gonna find if you go through some of these pharmaceutical companies like Bristol-Meyers Squibb or GSK is they may request that you exhaust all other options through your nonprofits such as LLS, HealthWell, CancerCare.org or Patient Advocate Foundation. So I would suggest you go to them first, those nonprofit organizations. They do have income verifications. They will have a lot of information that's gonna be required that you give them. They can verify that you're actually on treatment, but finding out what medications you're going to be on, not only now, but later on in the year. If you anticipate changing your medications, you wanna make sure you have the right insurance. You need to make sure that you can get positive biosimilars if you're gonna be on a brand drug like Revlimid when there isn't a generic linoleumide. But I would encourage you all to go to Health Tree's financial resources. We're gonna be updating those as we get new medications in. And this is not just gonna be for myeloma, it's gonna be for AMAL, for CLL, for all these other medications. We're gonna have a place where you can go to to find out what medications you're on, where you can get financial assistance as well. So we're gonna keep those things updated and for you all. So don't forget to look online. So reach out to your pharmaceutical company who manufactures or distributes your medication. You can look on your prescription, or you can Google that to find out what company makes that prescription and see if there's any biosimilars as well. Next slide. Many pharmaceutical companies offer additional support, not just financial assistance. Sometimes they'll offer information about the medication and more additional information about side effects or how it could work with other drugs that you may be taking. There's a lot of information like Jensen has CarePath. There are a lot of programs out there for patients to find out about medications, maybe prior to even using it, if you anticipate that may be coming down the road. I would encourage you to stay on top of these things, stay on top of the medications you're on, anticipate what's coming up and keep up with what Medicare, if you're on Medicare, what Medicare programs are going to be, what's gonna be a formulary, what's gonna be all formulary. I know it's a lot of work, but it's gonna save you money out of pocket. It's gonna save you a lot of headache down the road. So there may be income caps available, income caps that's going to prohibit some people with high incomes to assess any financial assistance, or it may be limited based on your assets. Some pharmaceutical companies may provide medications to bridge the gap between insurance coverage to help you get on treatment as soon as possible. Maybe there's a prior authorization, the doctor says you need to have this medication. Then there may be a additional form to the pharmaceutical company where you can start that medication until everything else is lined up and in place. If this is an issue, alert your doctor or oncology nurse navigator, which means you need to know your insurance before you do that. They may be able to assist you getting the assistance you need. So don't hesitate to talk about, even when they prescribe a new drug, say, can I talk to somebody about the cost of this drug? Even if you have to go there directly to the financial part of your office so they can start looking at your insurances immediately. Next slide. So when you receive financial assistance from nonprofits or from the pharmaceutical company to cover the cost of your medication, it is tax-free to you. You don't have to report it to your taxes. It's not going to increase your income at all. So you don't have to report it. So however, when you receive those, it's going to be paying for co-pays, deductibles, co-insurance, those things, but it does not count toward your deductible. So whatever you get, you can't reduce your deductible that is required in your insurance plan by that amount. You still have to meet that deductible to get the additional reductions in the cost of your insurance. So it is a service that's provided by nonprofits and through pharmaceutical companies to assist you in getting your medications. However, your deductible will still be in play. That's very important if you understand there are other medications or if you know there's other medications you're on, maybe diabetes, drugs, health, blood pressure, and all those things, those can help towards your deductible because it's all coming out of your same insurance plan. But as far as getting, reporting that grant on your taxes to help reduce that deductible, it is not going to work. Next slide. So again, keep notes on everything. I would encourage you every year, get a binder. If your insurance, especially if your insurance changed, get a binder and whenever you go to the doctor, have an area assigned for your doctor visits, for your labs, for your medications. So that when you start getting bills in, and I would ask for itemized bills, you can match those with your evidence of benefits to verify that what you're actually paying, your co-insurance deductibles out of pockets is actually going to match. Because if you're paying more and you keep getting billed and you're not looking at your ELBs, you may be paying more than you should be because if you've already met your max out of pocket, especially if you're going down toward the end of the year, September, October, if you have a high medical bills, then you may meet your out of pocket or deductibles max out of pockets fairly, fairly soon in a year. Your insurance, your providers may continue to send you bills, but if you haven't matched them, you don't want to pay those bills until you get your benefits of coverage and verify you've actually made your max out of pockets. You don't want to pay more than you need to. If you have any contact with providers or insurance companies regarding the cost of treatment, including prescription charges, make a note as to who you spoke to the date, time and nature of the call. It's going to help you down the road if you need to challenge that. If you receive any grants, keep a notebook of whom you received it from and the date and when it can be renewed. Again, this is very important, especially when some of these nonprofits are running out of money earlier in the year and they may come online, but they may go out again. You need to know when yours is going to be running out for the year. You can only get it once in a 12 month period of time. And that's not from January to December. If you started in March, it'll go through February the next year, but keep a note as to when those can be renewed. Also note as to how the funds are being spent, whether it's through medications, co-pays, deductibles, premium reimbursements, et cetera. So you'll know how to use it for the next year. And you keep an idea, maybe you're not using it all on co-pays, maybe you need to have reimbursement for premiums. Keep an idea of how your money is being spent or the grants are being spent every year so you'll know how to make adjustments for the following year. Next slide. So how often, I get people ask me this question, how often can you get financial assistance? Well, usually with nonprofits like Leukemia and Pharma Society, HealthWell, Patient Advocate Network Foundation, you can reapply every 12 months. Receipt, your receipt will be depending on available funds, which means they run out early. If they don't have funds available, they can't give you any funds. It is first come first serve basis. So you need to keep up on those things. You can also apply to more than one organization. I tell people if you apply to like HealthWell or to LLS, you can say, well, my LLS is gonna cover my return of premiums for my Medicare premiums, right? And then you can call and say, HealthWell, if they have funds available, say I need assistance for you to pay for co-pays or whatever other things that the LLS is not covering. I've known people who've gotten several of these grants, and some could be 12 or $13,000 each from each provider, different organizations. So don't be afraid to ask. The worst they can do is say no. And then maybe they'll call back and speak to somebody else. We know how that goes. If funds aren't used in a timely manner, because they'll tell you you need to use your card, you have times they come on these credit cards, you may forfeit your remaining balance. You can still reapply the next year though. So keep up with the times, keep up when yours is gonna be running out and how your money is being spent. Next slide. Some pharmaceutical companies may require you to exhaust, again, I said this earlier, nonprofit organization, financial programs prior to requesting funds from them. And they also have these parameters that you need to, if we're to qualify like 150, sometimes up to 500% of your federal poverty levels, and the federal poverty levels based on how many people are in the household. So don't just look by your income is how many people are in the household. Additionally, some financial assistance, maybe one time grants such as funds for urgent needs through LLS and Catholic charities, which is I think $500. They, and you look for one locally to you. So you may have more than one Catholic charity depending on how big your city is, that may be available to get funds from. Now here we are in beginning of new year. They may have funds available now for the beginning of the year. Some of the Catholic charities had exhausted their funds earlier because the need was so great last year. So I would check with those Catholic charities, not just the one local, very, very local to you, to maybe another city over or county over that may be available to you. Next slide. So what kind of information are you going to need to provide to both the pharmaceutical company and or the nonprofit organizations such as LLS? So there, when you call them or you put in your application online, they're going to ask you what your income is. So they're going to need to verify your income. They're going to need information about your doctor. They're going to need to know that you're on treatment. So they're going to send a form out to your doctor. And this could be where a time things slow down. So I'd encourage you once you fill out that application or you call and talk to them or they send it over to your doctor, which means they're going to need your fax number, the doctor's name, telephone number and address. So they can get that to the doctor, call your doctor, let them know that that's coming in so they can expect it. Follow up every couple of days and say, has it been done because they run out of funds? I need to make sure I stay on treatment. That is something I would encourage everybody to do so that you won't have a time lapse in your coverage and be able to get the medication that you need. Again, they're going to ask about what type of insurance you have, especially if you have some differences between Medicare and private pay, because there's different programs for each one of those. And if you think your income is changing, huge, if you think your income is changing during the year, such as you're no longer going to be working, you're retiring early, your income is dropping, let them know that because that may allow you to qualify even better versus having high income and all of a sudden they're just looking at last year's. Let them know your income is going to be changing during the year. It'll drop you into that category of income caps. Next slide. So if you, I think we went back. Okay, so if you have Medicare, can you still get assistance? Yes, you can. You can say that a lot of people have Medicare, but they're not fully covered. They may, it's almost like underinsured. So I would, again, when you call the pharmaceutical company for their financial assistance programs, tell them you have Medicare, do you have assistance for Medicare patients? They don't want people to fall off treatment. They want you to continue to get the medications from them. So they're going to try to help you. Non-profit organizations have benefits for Medicare patients that may not extend to private pay. So there's a lot of qualifications or difference between private pay that's insured through your provider, your employer or your Medicare or Medicaid. And check to see if they offer reimbursement for premiums. That's huge. So that you can use, perhaps if they reimburse for premiums, then you can use that other additional money that you have to pay for your co-pays and deductibles. Next slide. So when do you apply? As soon as possible. Like right now, we are already going into, we are in our second week of January, time flies. Look online now and keep it your calendar. Maybe every, let's say the first of every week or the Friday of every week, go online and check to see what's open. So you won't miss some organizations that have some fundings that are available. If they're closed, again, check back often. Often, I would say every week, because they do close and they open up at a later date. And sometimes may be open for a day or two. So you need to keep on top of that. Because they will, and also they'll need to send verification of treatment to your doctor. And it's gonna take time for that to come back. Make sure your alert is coming and encourage them to return it as soon as possible so that you can get that grant. You don't want somebody else to have gotten that grant money that you need, because your application or verification of treatment is sitting on the doctor's desk. Next slide. So where can you find some financial resources? Financial and helpful resources at Health Tree for Multiple Myeloma. And again, it's not just multiple myeloma, it's for blood cancer patients. Financial Myeloma Coaches, free one-on-one consultations. We will have access to a lot of this information. If you need help, please talk to a financial myeloma coach. Or I would say financial blood cancer coaches, because we are working with not just myeloma anymore. And then you go to Conqueror Magazine Patient Resource Guide. There's one out there. You can download it if you need one in hard copy. You can go to Conqueror Magazine, and they will send one out to you. There's free of charge. And it'll break it down based on the pharmaceutical, or break it down based on other programs as well. You can Google resources support for your specific needs, but make disease, but make sure to vet any organization before giving out personal information. You have heard, especially recently, that there's a lot of people who are going online, and people are being preyed upon, because they know there's a need. They know people are desperate for help. And there are some bad players out there who's waiting for you to give out information. Verify that. Look the URL, call them. Verify that information before you give out personal information. Like your lls.org, your patient advocate care, your healthwell.com. Those are all trued and tried. I wouldn't worry about those. But if you find something that's a little bit off, spelling maybe off, or just looks different, I would verify that information before, verify that organization before you give out information. Next slide. So here are some, again, we're gonna summarize what we went through. We went through where you can find financial help, how to verify that you need help, talk about your insurance, can you get more than one type of assistance, all these things. Your best financial foundation is to make sure you have the best coverage for your insurance. Every year, every year, for everyone, no matter what your insurance is, whether it's private pay, whether it's federal program, you need to review your program every year, especially when some of the Medicare Advantage plans are being terminated from some of the healthcare providers. Make sure you ask your doctor what changes may happen with treatment in the near future. Because if there's an option to maybe switch over to a different plan, if you're gonna lose something, then you need to know what's available before you have a cease in coverage or a lack of coverage. Keep a record of everything, including approvals for assistance. Be aware of surprise changes mid-year to Medicare Advantage plans. Check for generics if possible because you have a less cost out of pocket, and reach out to a health tree and financial coach. And we will be glad to assist you in your financial assistance programs or anything else financial, such as American with Disabilities Act, FMLA, appeals for SSDI or SS Social Security Disability Income, or SSI, any of those things we'll be glad to assist you with. We're waiting to have people call us. I think that's it, and I will be opening it up to questions. I know this is a lot. We have a lot of resources online that will really, really help you guys. And we can even help you with applications if you need to get online. We can get online you with a three-way with the pharmaceutical company or with a nonprofit to help you with that process. Awesome, thank you, Diana. Thank you for your preparation and also just for presenting today, taking the time. I know several of you had questions about specific things that Diana said. I just wanted to remind everyone, as I forgot to mention it in the beginning, that these slides will be sent out to all registrants via email along with this recording. And that's gonna happen within 48 hours of the event's conclusion. Just one second. Sorry, I woke up with a unwanted cough this morning. We have a couple of questions here. I did put already something that's hyperlinked in the slides here, which is, I put it in the chat as well, which are those financial helpful resources that you can find on our website. One of the questions here that you did cover was do drug companies help Medicare recipients? I think this is a common question. And if there's any specificity that you would like clarified, let us know within that question. Here is Medicare Part D and Part C Advantage Plan treated the same regarding assistance. Medicare Advantage, they have their own prescription plan attached to it for most advantage plans. They are considered the same. Medicare Part D is a prescription program under the Medicare arena or umbrella. So yes, they are treated the same. Wonderful, thank you. There's an attendee that would like you to list all of the ways that they can receive resources. I only laugh because there's so many that I think it would be kind of impossible. I can review a couple that I heard you say, that Conquer Magazine one, I can go back here to this ones that are linked. So the really important one is this first one where it's gonna list several. So if you click that website, it's gonna list several, including HealthWell, which Diana mentioned several times, including LLS, which is the Leukemia and Lymphoma Society that is a well-known nonprofit for providing grants. Those are gonna be found here on this first link. Another thing that I would suggest simply because your own personal financial situation is gonna affect what resources are right for you to access is talking to a Myeloma financial coach one-on-one. These are confidential sessions. It's not something that they're gonna share with anybody that they know. It's a private meeting where you're able to ask questions and get personalized help like Diana was explaining earlier. So that's something that I would suggest for everyone if you're interested. And then also this Conquer Magazine patient resource guide is really good. It's downloadable like Diana said, and it contains again, a plethora of information. So it's not just one or two resources, it's several resources. And so what I want to stress to you, to our audience today, or to anyone who's watching the recording, this is a big deal and it is gonna take time. And there are so many organizations that you could look into. It can be quite frankly, a frustrating process if their funds are expired or not open and you have to check frequently. But that being said, that silver lining that there are so many options. Diana, I don't know if you wanna add anything to that. No, but if, again, if you have a hard time trying to find some of those resources that Conquer Magazine, they just put out the one for 2024, which they're unbelievable. And they keep up with everything. If, and I have other resources as well. If by any chance you don't have access to download that and you may want need to print it, please reach out to me, call me, because I have stacks of books here. I'd be glad to send one out to you. I'll be glad to send out whatever resource you need. Awesome, thank you Diana. Question here, is there any drug program you would recommend with Medicare that may help with Revlimid or the generic? So this is something that you talked about in the beginning. Several people were not here in the beginning. Our direct link emailed didn't go out until later. So if you wanna just briefly touch on this again. Yes, if you have, again, if you have Medicare, then they want you to exhaust your pharmaceutical, your non-profits. LLS has closed, but I think Patient Advocate Access has available funds and HealthWell has available funds for Medicare access. If they don't have it, then go to your pharmaceutical company, McKeeson, mckeson.org is a pharmaceutical provider. They have funds for the generic of the Revlimid, linoleumide and then GlaskoSmith, oh, sorry, Bristol-Meyer Squibb, have funds for both Medicare. If you don't have full coverage for your Medicare, for your, especially your Revlimid, they have other drugs as well. And for private pay for your Revlimid, that's your big cost drugs. There are other organizations that are also held for your Velcade, linoleumide, I mean not linoleumide, dexamethasone, some of the other medications you're taking. And I'm mentioning, happened to be mentioning your myeloma drugs, but it goes for your AML, CLL, your leukemia drugs as well. Thank you. I'm gonna have these written as well in the actual email that we're sending out as this is really important information. Tell me one more time, the Patient Advocacy Organization. Patient Advocate Foundation. Now all of that, everything that's written out for each organization with telephone numbers is in our financial resource, our financial source guide. Yes. If we just give you two, we don't want you to forget that realize there's others out there as well. Please hold on, it's right there. Yeah, so that she's talking about, let me pull this up so you guys are aware. She's talking about this first link right here. That's where you're gonna find all of these things that we're mentioning, although I will kind of spell them out so you know which ones to look for if you were particularly interested in something that she said. And again, you can connect with a financial coach. This doesn't have to be a Zoom meeting. It doesn't even have to be a phone call. It can be via email that you guys go back and forth. It can be via text. Whatever way you feel is most comfortable to communicate. Our financial coaches are willing and ready to communicate with you for completely free because we want you to avoid financial toxicity. It's as simple as that. So hopefully that helps. Okay, question here. If we get copay assistance, which reimburses us on the high-cost drugs, do we even have to worry about the Medicare Donut hole since copay reimburses us? That's interesting because when you're talking about reimburse, we're talking about a specific drug, right? Or a couple of drugs. You may still have other drugs for other preexisting comorbidities like diabetes and heart medications or whatever. That could be still very expensive. That's still gonna take you into possibly that donut hole which is closed off. Hopefully by next year, you only have $2,000 max out of pocket, which would be great. But yeah, you may still have to be concerned about, especially if you're on other medications as well. Again, it's not gonna apply towards your deductible. What you're getting these grants from is not gonna apply to your deductible. Your deductible is still gonna be hanging out there. You're just getting assistance for a drug. Yeah. Are myeloma medications under part D? If they are. Just to clarify, this is Medicare part D. Right. If they are medications, oral medications, they will be. If they are infusion drugs, then they will be under your Medicare part A, I believe. A or B. A, A. Yeah, that's where it gets tricky. And so again, if you just wanna, I keep saying this, but if you wanna review with a financial coach, these are the things where it's so hard to keep track of and we don't want you to feel like you have to keep track of it alone. So again, we're here to help. What are the usual income limitations to be eligible for these assistance programs? It depends under whether it's pharmaceutical. They may have 150, maybe 400, 500% of federal property level. Your nonprofits may have federal property levels as well included or income amounts. I do know there have been people who've gotten assistance through pharmaceutical companies. They get incomes of 112,000. So it's very generous, especially pharmaceutical companies. Now your nonprofits may be a little bit more strict, narrow in their scope of income, but it's gonna vary among organizations and pharmaceutical companies. Awesome, thank you. Terry's saying, I read that it's better not to do the Advantage Plan with Medicare because it's very limiting. What are your thoughts on this? Before you go into it, I will say, Terry, we have specific webinars on this very topic that we can put as part of the resources. I'll let you briefly answer that, Diana, but just so you know that we have full webinars on this topic, because it's a common question. Right, especially with everything going on with a lot of Medicare Advantage Plans being terminated, that you are limited scope. Your in-network is very, very limited, but they do have HMO and PPO's. PPO's are a little bit more broad in scope, but they're still Advantage Plans. Advantage Plans require a lot of prior authorizations. Personally, what I've heard and what I have experienced or other people have experienced, I have found that your Medigap, if you qualify for Medigap, you need to get Medigap as soon as you initially can qualify for it and that H65 is always the broader coverage. The premiums may be more expensive on the front, but they cover more. So again, you need to do comparisons, but be aware that the Medicare Advantage Plans are gonna continue to be terminated from providers because the providers are not getting the pay that they used to for Medicare participants and prior authorization is becoming a very, very, big problem with doctors and with patients. So if you have that option, I would still go through a Medigap Plan if you still have that option. Awesome. Always get PPO over HMO, always, if you have that available to do that. Perfect, thank you. She says thank you. Darzalex is very expensive. Darzalex is also known as Daratumumab for people who are wondering, do you know of a generic, I'm being charged quite a bit of money after Medicare and secondary PACE? I'm not familiar with the generic verbose, similar for Darzalex, maybe one coming down the road is one of the fairly newer drugs. Again, call the pharmaceutical company for assistance. They do have assistance for those drugs. And that's what I was just gonna say as well. This is where really using those pharmaceutical programs come in because I had several friends who are patients as well that were being charged similar amounts after connecting with the actual pharmaceutical company and accessing their resource programs. They were down to paying very, very little out of pocket. So it's frustrating, I think, that as you were saying, well, maybe you were saying in that video that I was showing beforehand, but the doctors are so full of thinking of everything else and even the nurse navigators. And even when you're sitting in that session yourself as a patient or a caregiver, it's not one of the things that you think to ask. Give me a list of extensive resources so that I don't have to be paying anything out of pocket. Because now it's months later and people have been paying these astronomical out of pocket fees. And then they realize, wow, there's really a lot of resources out there that can help me. So Jack, make sure to check out the pharmaceutical. And again, on this financial and helpful resources link that we have on our website, you'll be able to see even, like, do we still have that, the drug name, and then how they can receive help for that specific drug? Yeah, I had a patient call me last, way before last, and he had Revlimid and several other drugs, and it was costing him $1,800 a month out of pocket. And I said, you need to call this person. And he got online and two days later, he said, I got everything paid for. He said, I am no longer paying that out of pocket. And I mean, it's amazing. I didn't know about any of these resources until after my husband had died. I had no idea it was out there. So that's why I'm trying to help you guys, because they're out there. And again, doctors are, they don't ask about the cost. They're gonna tell you what treatment is. They're not gonna ask you about the cost of care, can you afford it? But it's your responsibility to say, how much is this drug, how much is it gonna cost? And can I get help? Is there somebody here to help me? Yeah, definitely. Okay, will the assistance programs pay for any drug that is prescribed by my oncologist, even if it's not specifically a chemo medication, for example, acyclovir, which is the shingles. Acyclovir is covered under certain programs. And a lot of times, if you go, if you have the option to go through a mail order, it's even less expensive than if you go to a pharmacy. So again, find out who manufactures your acyclovir and see how you can get assistance with that or get it through mail order, which is a lot less expensive. A lot of times your pharmacy can help you with some of this information. Yeah, that's what I was gonna say, like listing out people, like, you know, your doctors are really busy. They may not have all the information. They may want to help, but just not have the time or capacity. Nurse navigators can help, social workers can help. Even at the pharmacy, they can help. And so just being aware of asking everyone that you can, what are ways that you can help me? What are, you know, ways to make this more affordable? Just kind of, again, it's putting yourself out there. It's taking a lot of work, unfortunately, right? But it's worth it if you can find resources that help you, you know? You wanna know the fastest and easiest way to do something? Get online and Google, financial assistance for a cyclotheater, financial assistance for cancer drugs. Do it, and it's gonna list out all these organizations we've mentioned, as well as maybe others, it's made of local organizations. That's the easiest, fastest way. Yeah. But as we said earlier, be careful. That's right. Okay, not on any chemo or meds now. How do I choose a drug plan for next year? I think really with this one, it's having constant communication with your provider, even if you're not seeing them. You know, what is my next step? What would be my next treatment if something were to happen? I think just always having in your back pocket the ideal next treatment that you and your provider have decided together. Would you add anything to that, Diana? No, I think that's absolutely right. I mean, that is being involved in your care. And being proactive. You don't wanna sit in the back seat and wait for somebody to say something when you, and it's too late to make changes or too costly to make changes. Yeah. Drugs, including daratumumab don't have a generic. That's true. Currently, as Diana said, you know, the generic that we're talking about today is linoleumide. It's the generic of Revlimid. Daratumumab does not currently have a generic. So we just, yeah. Unfortunately, cancer drugs don't always have generics. And sometimes the generic is either not as good or not as cost effective as we would hope it to be. Or available, as available. So again, that's why we're trying to teach you all of that, all of these financial resources. Okay, question here. How can we determine which mail order pharmacies are safe and reliable for drug quality and prices? You can call your insurance company, your whoever has your, like your pharmacy can tell you mail order. Whoever you have in your insurance provider, your insurance carrier, they can provide, tell you what mail orders available for your drug. A lot of times you may have to go through a certain thing. Like if you CVS, you may have to go through Caremark based on that insurance company. So, or Optum, you need to ask them where you can get mail order for your drugs. That's a good resource. I wouldn't have thought of that. So thank you. We do have time for a couple more questions. If anybody had a question but was hesitant to ask. I'm gonna briefly show them the screen that we were, so when you click on that financial and helpful resources that we've been mentioning, I just wanted to show you guys what it looks like. So there's financial resources here. You can start with these pharmaceutical companies. So again, like we were talking about Darzelex earlier, this Janssen Compass program, I think they had changed the name actually. So I will, I'll go through this Dana and I will go through this. We kind of always periodically check in on this. During the new year, people have changed their names. So when it comes to pharmaceutical companies. So we'll make sure that all of this is up to date and accurate. If you guys happen to find something, links that aren't working or inaccurate resources here, just feel free to email us and we will definitely help you or update this information accordingly. Other patient assistance programs. So some of the ones that we've talked about here are these Health Wealth Foundation grants. There's a resources for single mothers, Leukemia and Lymphoma Foundation we talked about today, the National Cancer Institute, this Patient Access Network Foundation, the Patient Advocate Foundation, like Diana was talking about. There's basic living expenses help, child care expenses help, equipment supplies expenses help, government assistance help, home health care assistance, housing during treatment, insurance premium expenses, legal issues, medical care expenses, post-treatment financial needs, prescription expenses, kind of what we're talking about today, travel assistance and then other helpful resources that might help you. We also, Diana mentioned she had shared on our financial connect group, more information about Medicare coverage, Medicare Advantage coverage. So you can come here and look at our Health Tree Connect. It's social media, but just for multiple myeloma. Other blood cancers, we're starting up Connect for other blood cancers as well. And then Facebook groups if you'd like to join them. But I wanted to show you that we're serious about providing a plentitude of resources for you guys because we're serious about helping you avoid financial toxicity. I don't know, do you just still do surveys after these? Yes. Okay, so if we could put a survey in or question in if it's available, if possible, to find out if you're a caregiver, if the caregiver needs resources, because I'd like to start putting together caregiver resource information. I think caregivers are lost. The one that they'll see right after this meeting has already been put in. So it would be possible to add a question right now. But before we send out the follow-up email, we can add that question if anybody is a caregiver and seeking specific caregiver resources. Yeah, because there's a lot of states are now with a little training will pay caregivers to take care of their family members. Okay, I'll just add that here to my notes. Question added to survey. Okay, a couple more questions. I have good private insurance, but we'll be 65 soon. Should I start figuring out now which Medicare programs I should get? If you're gonna be 65 this year, yes, because you're gonna probably be on Medicare this year. And again, call me so we can look at the options in your state and look at what, if you wanna look at Medicare Advantage or Medicare Gap Plan and compare the costs and everything available for you or you're gonna be responsible for. Wonderful. CVS specialty is great for Revlment or Linolinamide they're saying, so that's great. I love when you guys share resources with each other. All right, well, wonderful. Thank you so much again to our audience for attending today, for taking the time out of your day to be here. It's great to jump into the new year with good information like this. Diana, thank you for your preparation and for your presentation. Are there any concluding remarks you'd like to make today before we finish up? Oh, I think you're muted somehow. I think we're good, but for any patients who are African-American patients under Black Health, myeloma health or AML patients, we're gonna be covering some, maybe some things that are directed toward you. We're gonna have some invitations that'll go out this month for the Black Health, myeloma health as one for AML for next month. So jump in on those. Wonderful, thank you. We'll finish up with just a couple of outro announcements. Our next meeting will meet every other month this year. So our next meeting will be in March. It will be March 5th, and we'll be talking about preparing for your 2023 tax filing. So between now and then, start collecting all of your records, your receipts, anything that you might need as Diana is gonna coach us through preparing for this 2023 tax filing. Then other upcoming events. Tonight we have our SoCal, it's actually Pacific, I just remembered. We expanded the region and changed the name. So the SoCal myeloma community is now the Pacific myeloma community. And we're gonna be talking about New Year New Plate Healthy Eating for myeloma patients and their partners. Then on the 16th at 5 p.m. Eastern is our plasma cell leukemia chapter. We're gonna be hearing from Dr. Sporoff about his recent plasma cell leukemia clinical trial and what this means for PCL treatment. And then on the 18th at 1 p.m. Eastern is our newly diagnosed myeloma chapter. We're gonna be talking about understanding fish, genomics, and myeloma genetics with Dr. Sivanasankha. So all of those events are on our website. If you wanna click on the link when these slides go out, and then there's other events that I have not mentioned that are also on the site. A special thank you to our sponsors, Bristol Myers Squibb, Adaptive, Amgen, Janssen, AbbVie, GSK, and Regeneron. And thank you to all of you for helping us build this myeloma community, especially the financial community. I really invite you to participate in the financial one-on-one coaching if that's something that interests you. Keep a look in your inbox as we're gonna be sending out the email with all of these awesome resources. Thank you again for joining us today. I hope you have a great rest of your day. Thank you, everyone. Bye-bye.