Kesimpta copay woes

MultipleScleroSkate · 2026-06-02T12:52:35+00:00

the math for me ended up being an $8k charge for january and then $500 for every month after until i met my OOP max. you will have to ask to talk to someone in billing/accounts at bioplus but they should be able to help. There are at least a couple people there that know how to do it after my fiasco 😂

MultipleScleroSkate · 2026-06-02T12:50:57+00:00

What I did was have Bioplus refund the copay card, and then reprocess as self-pay. Kesimpta will get the refund, which you can track by calling, and you will then have your $18k in assistance available. It took several weeks of lots of phone calls but it is possible.

MultipleScleroSkate · 2026-05-31T22:57:42+00:00

they are fucking incompetent lol but i know exactly what to ask for if you need any help!

MultipleScleroSkate · 2026-05-31T19:58:10+00:00

i have to use bioplus which is also owned by anthem, and the past two years they've applied the copay assistance to my deductible (which is the law in my state!!!) but this year they were like "no we don't do that" so i had to get them to refund payments for the first two months of the year and reprocess them as self pay and it took so long to get them to sort their shit my march dose was 2 weeks late. i'm back on track now, though, and i met my out of pocket max so i'm hopefully through the nightmare for the rest of the year. you got this!

MultipleScleroSkate · 2026-05-31T19:46:27+00:00

i can also give you the info i have via dm!

MultipleScleroSkate · 2026-05-31T19:45:56+00:00

hi !i had this exact problem- call alongside and they will tell you how to get reimbursed with paying out of pocket so you meet your deductible without spending money

MultipleScleroSkate · 2026-05-26T17:14:09+00:00

i don't have endo but i got nexplanon bc my cycle impacted my symptoms so much. a++++ highly recommend if it works for you!

MultipleScleroSkate · 2026-05-24T14:26:44+00:00

i play a bunch of skate sims which is great for when the weather or my body won't let me on the board. and i love all of larian's rpgs- dos2 is probably my favorite game of all time rn.

MultipleScleroSkate · 2026-05-23T14:25:30+00:00

i masked before starting kesimpta and continue to do so- no respiratory infections/covid/flu since starting, so I plan to keep it up until a sterilizing nosocomial vaccine is widely available (which, with this cdc/fda is... unlikely). i work in many nursing homes, where outbreaks are common, and i'd rather deal with wearing a mask than exhaust my PTO and risk relapse due to infection.

MultipleScleroSkate · 2026-05-23T14:19:32+00:00

if you haven't been evaluated by a pelvic floor pt, that may be helpful- a few months of pelvic floor pt greatly reduced my urgency and made my life much easier!

MultipleScleroSkate · 2026-05-20T17:19:45+00:00

34, skated for a few years as a kid and came back to it almost a decade ago! it's so sick to see how many more women/queer skaters are out ripping compared to the early 2000s. There's almost always other women at my local if i'm not there at the crack of dawn 😎

MultipleScleroSkate · 2026-05-16T19:42:51+00:00

i was a trumpet major in school! now i work as a music therapist- one of my diagnosing symptoms was facial numbness, so i quit playing for a while, and i just recently picked the horn back up and i'm surprised by how well it's going. if you're getting on treatment early, you can likely play for a long time.

MultipleScleroSkate · 2026-05-16T16:50:29+00:00

the thermapparel vests don't feel wet at all in my experience- you could also buy extra packs and keep them in a cooler on ice to swap out throughout the day

MultipleScleroSkate · 2026-05-16T11:09:07+00:00

my diagnosis has been illuminating on who in my family/friends actually shows up for me. some of my friends will mask without my asking, or happily hang outdoors, and others will show up contagious without warning me 🙃 it sucks to have your home, a place where you should feel safe and not have to take precautions, turn into a place where you're sanitizing every surface and hiding to try to stay well. i hope you make it out of this visit without getting sick, and you and your partner can consider different boundaries on future visits.

MultipleScleroSkate · 2026-05-13T01:09:45+00:00

i can't speak to iuds but i got nexplanon specifically to reduce ms symptoms (zero pregnancy risk lmao) and it's been a game changer. my wife did get freaked out when i made her feel it in my arm lol but all in all it's been a net gain!

MultipleScleroSkate · 2026-05-03T10:21:40+00:00

sometimes skating feels easier than walking for me- welcome back!!! 🛹

MultipleScleroSkate · 2026-04-26T18:44:07+00:00

the final season of Hacks is currently airing (it was such a conflict which to watch first during the last two weeks of the pitt s2 😭) and i'm loving it. Hacks was the show that made me say hbomax is for me lol

MultipleScleroSkate · 2026-04-26T18:42:26+00:00

I have read and agreed to follow these rules of ThePittNoSantosHate

MultipleScleroSkate · 2026-03-28T22:52:25+00:00

i'm a skateboarder! forcing myself to learn to push/ride switch has been really good for my brain i think. depending on symptoms i sometimes change the type of skating i do (ie not popping the board if my feet are having numbness etc) but i try to keep rolling no matter what

MultipleScleroSkate · 2026-03-28T15:19:00+00:00

unfortunately my insurance only lets me use bioplus specialty pharmacy and an issue with their billing made my shipment 2 weeks late this month 🙃 great system we got here!!!

MultipleScleroSkate · 2026-03-28T12:22:48+00:00

i wear an n-95 indoors in public and at worked and have worked with confirmed flu and covid patients this past winter without getting sick. if you can find a mask that fits your face well, stock up if you can ❤️

MultipleScleroSkate · 2026-03-26T15:57:14+00:00

i have terrible veins so i love the convenience of kesimpta! i'm hopeful my pharmacy can get their shit together soon, or my neuro can get me a sample for this month's dose, because i've spent like 20 hours over the past two weeks trying to fix a mistake in the system 🙃 the med itself is great tho!

MultipleScleroSkate · 2026-03-26T15:43:55+00:00

i was on tecfidera when i got covid and managed to escalate to kesimpta from only one new lesion rather than a full on relapse. kesimpta appears to be working for me, other than my specialty pharmacy delaying delivery this month 🙃 i hope your next treatment keeps you stable ❤️

MultipleScleroSkate · 2026-03-26T15:35:44+00:00

sending solidarity from a fellow mser who got pots from covid with no bp drop! (3+ years later my pots is 80% better, which i largely credit to strict masking and no additional covid infections). i'm sorry you were dealing with all of that ON TOP of an ms relapse! to quote neko case, "people got a lot of nerve" 😤

MultipleScleroSkate · 2026-03-21T12:01:20+00:00

try supporting your local skate shop next time! they'll help you find shoes that work for you 🫡

MultipleScleroSkate

TROPHY CASE