Have you ever felt like a trained dog jumping through hoops on command? I hadn’t either until I spent 3 months dealing with insurance and billing for an immunotherapy drug, Keytruda, that was a key part of my cancer treatment. Hopefully, you never have to experience this level of frustration, but just in case, here’s what I learned from the experience.
The nightmare started shortly after my first dose of Keytruda. My nurse coordinator through our insurance called to let me know that my prescription coverage wasn’t going to pay for the,
infusion. I do have to say that my nurse coordinator, Andrea, was amazing to work with through the whole nightmare. The bill for each dose of Keytruda is approximately $36,000 so I was very concerned. Andrea assured me that she would get insurance to cover the initial dose. For all future doses, of which I needed about 18 doses, I needed to apply for a Merk discount card; Merk makes Keytruda.
So I logged in and filled out the forms, and my doctor also filled out a portion of the information. I was approved for a $25 co-pay which was a huge load off my mind. The only catch was that Merk required that my Keytruda be compounded at a Walgreens compound pharmacy in Pennsylvania, which I thought was strange. And it turns out I was right to be concerned because this is where my billing nightmare begins.
The first dose of Keytruda went through with no issues. When it was time for the next dose
Walgreens called me and said I had a $1000 co-pay. Knowing that the amount was incorrect I refused to pay it and Walgreens wouldn’t release my Keytruda to me. It took my insurance nurse coordinator, my Oncology PA, and multiple other people to get the billing error sorted out. I was assured the problem was fixed. But it wasn’t, this went on for 3 months. Finally, I called the billing department at Walgreens and got someone who knew what they were doing. She told me everything was fixed and if I got any more calls to ignore them.
I still randomly get bills from them that are incorrect, but now they are quickly fixed. No one who is going through a major medical crisis needs this kind of stress. So if you find yourself in a similar situation save every communication and bill you receive, this really helped me. Also ask your care team for help, they will fight for you! And finally if you know the bill is incorrect don’t pay it, as it’s almost impossible to get your money back.
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