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That is entirely dependent on your insurance plan. Sag aftra has specialty drug coverage
"CVS Specialty for specialty medications Specialty drugs are high-cost oral or injectable medications used to treat complex conditions like rheumatoid arthritis, multiple sclerosis, HIV, psoriasis, rare genetic disorders and cancer. These medications will only be covered when filled through CVS Specialty. Visit cvsspecialty.com/DrugList for a list of covered medications that is updated quarterly. When your drug is on the list, you pay $0"
If you visit the drug list for oncology, it's fairly extensive compared to programs like Medicare or Medicaid.
That's what I was talking about when I spoke about specialty clinics that predate on wealthy clients.
Unfortunately if you are seeking bleeding edge cancer treatments your cancer is likely already advanced enough that your outcomes are looking pretty bad.
I can tell you, having gone through the CVS specialty pharmacy stuff for chemo medication specifically, it is absolutely not covered in the way you or they have said, and you absolutely do not pay $0.
Have you ever had cancer or had a family member go through cancer treatments? Because if you haven't, you probably shouldn't speak from a position of authority on things for which you have no direct personal experience with.
I have both had very close family members go through this and am going through something similar myself personally.
My copay is absolutely not $0 from CVS specialty pharmacy. Usually, for a $9k-12k prescription (Depends on the dosage they decide I need), I end up needing to cover around $2k/month, after insurance. And that's with having double insurance providers. Some of that can be helped out with from other assistance programs from the manufacturer, such as a manf. co-pay card, but the money I pay towards it does not count towards my out of pocket deductible, so I'm forced to also hit my OOP maximum from normal procedures that aren't related to the specialty pharmacy medication.
Additionally, health insurance has been covering less and less of my medications and procedures each and every year. So it keeps getting worse for me, and I assume everyone else, including those in the SAG.
It's dependent on your individual insurance plan and what kind of coverage you have....... This is the reason I said the Sag-aftra policy was pretty decent compared to most private insurance policies. The quote I gave is directly from the policy they currently have, which would be different than the policy you have experience with even if you utilized the same pharmaceutical company.
Yes, and Im a healthcare provider in a field where a lot of my patients population have been or currently are in being treated by oncologist.
While it's disheartening to hear that, that does not mean that is going to be the same for someone with a different policy than you. Sag-aftra has a very good policy because they have group bargained as a union to get the best care for their members. Which is different than most private insurance policies that are sponsored by workplaces who bargain to get their employees the cheapest policies available.
I'm not trying to make excuses for the American healthcare system of inequality. I was just pointing out that the union provided policy was particularly impressive compared to most. It's sure as hell alot better than my policy and I work for my state's largest healthcare provider.