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Medicare coverage for Stelara


Fri, August 13, 2021 10:09 AM

I am a 67 year old woman with Crohns Diseaser and I am trying to figure out how to afford the cost of Stelara.
Medicare Part B previously covered my Stelara injection as long as it was administered at the infusion center of the hospital.  Since Medicare paid only approx. $1,200 of the billed amount of $65,000, the hospital has discontinued provding the injections.  I now have to use Medicare Part D Supplemental drug coverage to have the injection filled through a Specialty Pharmacy at a cost of around $3,500 per injection.  
I've checked on financial help through the manufacturer but since my husband  (72) and I (67) still work, I'm over the income limit.  
I've taken both Enbrel and Humira (both cheaper alternatives) but developed Lymphoma and my gastro doctor doesn't think I should take that risk again.
Has anyone with Crohns Disease been able to find a way to receive a discount on Stelara?  Without any insurance, it is $25,000 an injection.

FPO ctg
Joined Jul 31, 2021

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FPO jamespotter
Joined Sep 14, 2021

Tue, August 31, 2021 7:26 AM

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