u/General-Musician7441

Hello,

My wife is currently working and has health insurance through her employer. She has Crohn's disease and had part of her small intestine removed about 10 years ago.

She currently receives home infusions of Entyvio every 2 months. Most of the cost is covered by insurance along with the EntyvioConnect assistance program, which currently provides up to about $20,000 in annual copay assistance.

As we look ahead to retirement in Florida, we’re trying to understand what costs and coverage look like under Medicare — especially Medicare Advantage plans.

I know many people advise against Medicare Advantage plans, but I’ve also read posts from some people who found Medicare Advantage plans that do cover Entyvio infusions. We would really appreciate hearing from anyone in Florida who is on Medicare Advantage and receiving Entyvio or other biologic infusions for Crohn’s disease.

Some questions we’re hoping to learn more about:

• Which Medicare Advantage plan are you using?
• Is Entyvio covered under Part B or Part D?
• What are your out-of-pocket costs for infusions?
• Are home infusions covered?
• Have prior authorizations or denials been a problem?
• Would you choose the same plan again?

Thank you in advance for sharing your experiences.