Does Medicare Cover Jakafi?
Fair Square Medicare

Does Medicare Cover Jakafi?

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By Daniel Petkevich

Dec 12, 2022

Good news; you're covered

For Medicare beneficiaries seeking treatment for myelofibrosis, knowing that you have coverage can offer peace of mind. Luckily, all Medicare Part D prescription drug plans cover Jakafi. Read more to learn about Medicare coverage and potential restrictions on coverage.

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What is myelofibrosis?

Myelofibrosis is a type of blood cancer that can cause anemia, enlarged spleen and liver, fatigue, and night sweats. It is rare but serious, so it is important to understand the symptoms so you can seek medical help right away if necessary.

What treatments are available for myelofibrosis?

There are several treatments that may be prescribed to manage the symptoms of myelofibrosis, including chemotherapy and targeted therapies such as Jakafi. Jakafi is a pill taken twice daily that helps reduce spleen size and improve anemia in people with myelofibrosis by targeting the protein in cells.

How does Medicare coverage work for Jakafi and other myelofibrosis treatments?

Medicare Part D plans cover Jakafi and other treatments for myelofibrosis. There may be restrictions on coverage, such as prior authorization requirements or quantity limits, so it is crucial to understand your plan's terms before beginning treatment.

You can review your plan's formulary (list of covered drugs) to learn more about your plan's coverage and restrictions. If you need help understanding or navigating your plan, contact your Medicare Part D plan provider or the Centers for Medicare & Medicaid Services (CMS) at 1-800-MEDICARE (1-800-633-4227).

Generally, Jakafi is listed as Tier 5 on many Medicare plan formularies, making it among the more expensive drugs covered by Medicare. Your out-of-pocket costs will be determined by which coverage phase you are in. Talk with your Part D prescription drug plan provider to see how much you can expect to pay.

Questions to ask your doctor about myelofibrosis treatment?

When discussing treatment with your doctor, it is wise to ask the right questions. Here are some examples of questions to consider asking:

  • What treatments do you recommend for myelofibrosis?

  • What are the benefits and risks associated with these treatments?

  • How will this treatment affect my lifestyle?

  • What side effects can I expect from this treatment?

  • Does my Medicare Part D plan cover Jakafi and other medications for myelofibrosis?

  • How much will I pay out of pocket for my medication?

Understanding your coverage is an important part of treating any condition, so ask your doctor these questions and any others you may have. With the right information, you can make informed decisions about your treatment and care.

Tips for living with myelofibrosis

Living with a serious health condition like myelofibrosis can be difficult. Here are some tips to help manage your symptoms and keep you feeling your best:

  • Stay active by doing light exercises like walking or swimming.

  • Take advantage of available resources, such as support groups or counseling services.

  • Eat a healthy, balanced diet and make sure to get plenty of rest.

  • Talk with your doctor about any concerns or questions you have.

  • Stay up to date on your medications and treatments.

These tips can help make life with myelofibrosis more manageable. If you’re ever feeling overwhelmed, talk to your doctor or reach out to a healthcare professional for help.

Conclusion

Myelofibrosis is a serious health condition, but it can be managed with the right treatment and support. Jakafi is covered by most Medicare Part D plans. However, there may be restrictions on coverage. Make sure you talk to a doctor before taking any new medication, including Jakafi. This content is for informational purposes. For all your Medicare-related questions, call an expert at Fair Square Medicare.

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