Erleada is a common prostate cancer drug. Some Medicare plans and parts of Medicare cover Erleada but Original Medicare doesn’t. Erleada is very important for those who use it and can be very expensive without coverage.
What is Erleada?
Erleada (apalutamide) is a medication taken orally to treat non-metastatic prostate cancer. Erleada comes in tablet form, and you’ll usually use four tablets per day as your health care provider prescribes. It is a useful medication but can be expensive for those who have to pay out of pocket.
Side effects of the drug may vary from person to person. Like many other prescription drugs, Erleada needs coverage from a Medicare prescription drug plan, rather than Original Medicare. Make sure to seek medical advice from your healthcare provider if you think you need an Erleada prescription.
The side effects of Erleada will vary. They include joint pain, tiredness, decreased appetite, hypertension, and more. You can find more information here, and you should always seek more information from your health-care provider.
Is there a Generic Version of Erleada?
No, there is no effective generic version of Erleada at this time. The FDA may approve such a drug in the future, but not for now. In the meantime, Erleada is the most effective drug to use for non-metastatic prostate cancer. However, you should always seek additional information from the FDA in the future if a generic version becomes available. If a generic version of Erleada becomes available, your healthcare provider will likely inform you about your options.
How Much Does Erleada Cost?
Erleada is very expensive compared to most prescription drugs. The average cost of 120 tablets of Erleada is over $12,000. This means that each tablet costs over one hundred dollars. Without health insurance, this is very difficult or impossible to pay for the majority of people. Because of this, it’s especially important to make sure you have proper coverage. While the price of Erleada may change in the future, it’s unlikely to be affordable to most people without insurance.
Is Erleada Covered by Original Medicare?
Original Medicare refers to Parts A and B of Medicare. Part A and Part B both don’t cover Erleada. Part A insurance covers inpatient healthcare, and Part B covers outpatient health care. Although these plans can cover drugs that are given to you when you see your healthcare provider, tablets and similar drugs are separate from this.
Related Content: Medicare 101
Do Part D Plans Cover Erleada?
Part D of Medicare refers to plans that are cover prescription drugs. Each Part D plan will cover different drugs. These plans will use something called a formulary to tell you which drugs are covered. Formularies are usually divided into tiers that tell you just how much is covered for each drug. If you want to make sure that Erleada is covered, check your plan’s formulary.
Agent TipErleada is tier 5 on most Part D drug plans. It’s best to check the plan’s drug list (forumlary) to be sure as they change annually.
How Does Part D Work?
Part D plans function just like other private insurance plans. The information for each plan will vary, but they all have a few things in common. In 2020, the deductible for Part D plans is $435 per year. Although not all Part D plans will cover the exact same things, but Erleada coverage is common. Remember, even if Erleada is covered, make sure that you know which coverage tier it is on.
Read on: Medicare Part D Explained
Can Medicare Advantage (Part C Plans) Cover Erleada?
Medicare Advantage, also known as Part C, is a way of getting your Medicare benefits through a private insurance company. These plans will vary in price, but all have to cover the same things that Medicare Advantage covers. Part C plans may have a provider network, like other private insurance plans. These plans may cost more than Original Medicare, but many of them offer additional coverage as well.
Most Part C plans cover prescription drugs. These plans may cover Erleada, but you will have to check the details of the plan.
What Kind of Prescription Drug Coverage do Part C Plans Offer?
If you have a plan that covers prescription drugs, you won’t be able to buy a Part D plan. Like Part D, Medicare Advantage plans will use a formulary to tell you which drugs are covered. You should seek further information from the insurance company if you want to double-check to make sure you have the coverage you need.
Medicare Advantage prescription drug plans may vary just as much as Part D plans do. Because of this, you should research your plan in detail to make sure you understand the coverage offered.
Are There Other Ways to Save Money?
Aside from having a Medicare Part D or Advantage plan, there are other ways to save money on Erleada. If you have commercial insurance, you may be eligible for a savings program. The most common program is from Janssen Carepath. This program is for those who already have a health insurance plan. However, the program can help provide additional financial help, so you pay less out-of-pocket.
Agent TipIn addition to this, you can also use goodrx to find coupons and discounts on drugs. These may vary depending on which insurance you have, but it is an easy way to find additional savings.
With these plans, you can end up paying 0$ a month. You should seek out additional information to make sure these plans are right for you.
If your healthcare provider prescribes Erleada, you should make sure your plan will cover it. If you don’t have a Part D or Advantage plan, then the Janssen Carepath savings program is a good option. If you want to make sure you have as much information as possible about your options, reach out to us at 800-208-4974. We are independent of any insurance company, so your needs are always put first.