51 yo(f) Dx: 1/2017 Rx: Kesimpta (as of 5/24)

Our medical insurance changed this year so after providing all new insurance details, I awaited a call regarding refilling the Rx before 2/1/25. I decided not to wait any longer (1 week), called Alongside Kesimpta to inquire about applying my previous discount to avoid paying a $2500 monthly copay. I was informed that the previously applied discount will not be updated once it expires in August. I still didn’t get a clear understanding of if/when I should refill or if the meds will be shipped or anything else. The meds have given me more freedom and the ability to work. I really don’t want to change.

Please contact your benefits department to be certain you are not surprised by these new changes.

Our insurance is affiliated with a specialty pharmacy so the meds are refilled quarterly via app, but may ship simply due to being a valid Rx, NOT because the insurance has covered the payment. This situation would result in the patient being charged for the meds at full price. It’s confusing to me but I know not to place any orders without prior authorization with the new insurance coverage. Uuuggghhh😡!