April 27, 2011

Pradaxa Now Covered by Medicare Part D!!

Posted in Heart disease tips, Helpful Heart Links tagged , , , , , , , , at 8:25 pm by keepyourhearthealthy

A patient having his blood pressure taken by a...

Image via Wikipedia

The new Coumadin alternative, Pradaxa, has recently become available on the Medicare Part D formulary.  Medicare recipients finally have an affordable option to Coumadin.

The first Coumadin alternative for atrial fibrillation became available late last year and Medicare patients have been anxiously waiting for it’s inclusion in the Part D formulary ever since.  With a hefty out-of-pocket cost at $250 a month, Pradaxa was much too expensive for most of the retired community.

Even though Pradaxa prevents more strokes than Coumadin, has no interactions with food (not even spinach) and requires NO monitoring (seriously, no more fingerstick checks!), many seniors could not rationalize paying $250 a month compared to Coumadin or warfarin which can cost as little as $4 per month.  Now, 6 months after Pradaxa was approved by the FDA, Medicare Part D has multiple plans which will cover the cost of this expensive new drug.  By searching the website www.medicare.gov, patients will be able to find Part D coverage and compare prices for individual plans.  The monthly drug cost is still fairly expensive (from $30 to $50 a month) but this is still significantly less than out-of-pocket cost.

Patients who plan to switch to Pradaxa should confirm with their Part D provider that the drug is covered before trying to get the prescription filled.  Here are some important tips to help make the switch:

  • Your INR needs to be 2 or less before you can start Pradaxa
  • You must take Pradaxa twice a day!
  • You CAN take Pradaxa while also taking Plavix but only if your cardiologist feels it is safe in your situation
  • Pradaxa starts working within 30 minutes to 2 hours
  • Pradaxa is generally no longer effective if you miss 2 doses
  • You cannot take Pradaxa if you are also taking Rifampin
  • Pradaxa is not currently indicated for people with mechanical heart valves (although this may be coming within the next few years)
  • The pills expire within 30 days of opening the bottle
  • The most common side effect is heartburn (GI upset)

March 3, 2011

How to Find Out if You Are Eligible for Medicare, Medicaid or Other Healthcare Programs

Posted in Heart disease tips, Helpful Heart Links, Uncategorized tagged , , , , , , , at 1:37 pm by keepyourhearthealthy

A typical examination room in a doctor's office.

Image via Wikipedia

Healthcare is an expensive yet necessary part of life.  When times are tough, who do you turn to for help?

After getting bills from the doctor, hospital and testing centers you may be left wondering how you can possibly pay for it all.  Whether you had a simple doctor visit for the flu or if you were admitted to the hospital for a heart attack, you’ll probably get lightheaded when you see the bill.  Once you’re over the initial shock, then you need to work out a plan of action.  If you’re lucky enough to have a steady income, the first step is to call the doctor’s office, hospital or testing center who sent you the bill.  Most places will readily offer a payment plan with no interest and very low payments.

If you are currently unemployed or simply unable to pay for your medical bills, you may be eligible for government-funded programs like Medicaid or Medicare. The following website link offers an “Eligibility Wizard” quiz which will help you determine if you qualify for these types of programs:

http://www.realsolutions.com/healthcare/Pages/EligibilityWizard.aspx

January 24, 2011

The Latest on Medicare Part D and Pradaxa

Posted in Heart Disease in the News, Helpful Heart Links tagged , , , , , , , , , , , at 4:01 pm by keepyourhearthealthy

image by renjith krishnan

Medicare Part D is still not paying for the new Coumadin alternative, Pradaxa, but there is hope for Medicare patients looking to make the switch.

Ever since Pradaxa became the first alternative to Coumadin approved for atrial fibrillation, Medicare patients have been eagerly awaiting the announcement of prescription coverage with Medicare Part D.  Three months have gone by and some Medicare patients have already switched despite the high out-of-pocket expense.  Since Medicare does not pay for Pradaxa, patients are spending as much as $250 per month.

According to a Pradaxa representative, only the Military and Medco are currently covering Pradaxa.  The manufacturer has recommended several options though for patients on Medicare who need financial assistance.  A Savings Card is available by signing up for the Pradaxa Support Program.  The Savings Card gives Medicare and Medicaid patients one free month of Pradaxa and continued savings throughout the year. Even patients who already have coverage under companies like Blue Cross and Blue Shield can use the Savings Card to offset a high copay.  These patients will often pay only $30 a month when using their insurance and the card.

If the Savings Card is not a good option for you because you still cannot afford the cost, the Pradaxa representative suggested applying to a third-party assistance program such as Rxhope.com.  Rxhope.com can guide you through the process of receiving Pradaxa for free.  They even have an application specifically for Medicare patients who need Pradaxa.  You can also begin a financial assistance application by calling the manufacturer Boehringer Ingelheim directly at 800-556-8317.

Rest assured, Pradaxa will eventually become approved for coverage by Medicare Part D.  The manufacturer is working diligently on the application process.  Until then, they are hoping patients will benefit greatly by using the Savings Card or signing up for financial assistance.  Check here for updates in the future!