Let’s talk progress. GammaCore reached out yesterday (same day as the Rx was written) by text to make sure I was interested. Today they called to talk money and make sure I’m interested.
As is usual for my insurance, they won’t cover it. The cost of the thing is $598/month. The gadget is essentially free. You’re paying for charges that are given by days rather than uses. It has an internal calendar that gives you 31 consecutive days, and you use it as much as you need. They have a 12 month co-pay assistance program for cash and private insurance buyers but nothing for state of federal plans. The co-pay assistance is $300 the first month and $250 the next 11 months. That means out of pocket is $298 for the first month and $348 for the next 11 months. The second year is all on you at the full $598/month unless you can get your insurance to cover it.
They offered to work with my neurologist to try to force the insurance to pay for refills after the first month. We’ll see. I’ve done several appeals after Premera Blue Cross initially denied coverage and have won a few. More often I’ve had to pay out of pocket. (Which maybe wouldn’t bother me so much if I didn’t know the insurance costs my husband’s company somewhere in the range of $1200-$1500/month and I have a $7,300 out of pocket max I have to meet annually, but only for covered events. All other things, which in my case are a lot, are on me for cash. I’ve paid a lot in cash over the last few years, mostly for physical therapy and related care.)
You can quit the GammaCore at any time. They don’t ask for the device back, they just don’t refill the charges. In fact, they call every month to see if you want to get the next set. The device ships from Premier Pharmacy in California. I don’t know how the charges thing works but I bet it’s a code you get from GammaCore during that monthly call, cash up front.
I put away some money in my health savings account when my financial life was better. I’m going to use that to give it a 3-month trial and then see if I want to keep going. It arrives next week.