insurance

Just got a bill from last summer saying that before insurance coverage my remicade cost over 34,000 dollars per treatment. I knew it was high but I had no idea they were billing that much! luckily they have covered it but my coverage ends in two months. I am looking into purchasing my own insurance temporarily so I can keep most of my doctors. Does any one know, if an insurance company says that remicade is not covered, is there any room for negotiation if its declared medically necessity? Because so far I'm not having much luck and to say I'm a bit scared is an understatement.

Under Obamacare, they cannot charge you more for pre-existing conditions. Remicade is a pretty accepted treatment so I would think that most insurance companies would approve it if your doctor orders it. I would stay with mainstream insurance companies like Blue Cross even if it costs you more to do so, and then call and ask to speak to a case manager of whatever insurance company you are interested in. I am spending over $1000.00 a month in premiums to cover my daughter and myself and I still have a $2500.00 deductible per person before I get any coverage. It's very expensive but much less than paying for a biologic! The Republican proposed changes are another story......then god only knows what will happen to us!! Good luck with everything!

For $34,000 I'd want a week's stay in a 5-star luxury hotel with a chauffeur-driven trip to the poshest hospital in London at the end of it to receive my infusion.

@bania is right, it depends on the location. When I was getting them at my GI's office, it was around $6k each time. But now that I do it at the outpatient infusion center of my hospital because I'm a hard stick and need an ultrasound machine, it's over $30k each time.

Lab,

The learning hospital near me......and the infusion center....they both are very expensive. They both also have "grant" programs our GI's can get people in to.

I don't have any other answers..... I am sorry you are having to worry about this. It is not right for a medicine that people have to have to live is so expensive.

Hang in there

Clo

Hi all, thank you all for your responses. I am deeply troubled by all of this.
I will be finishing up my degree so my college insurance that has been covering me since I started dealing with crohns will be gone.
Yes it is done at the hospital endoscopy center. The doctor insists on it so that at least one doctor from the practice can be there during infusions.
I can only find two policies available through the state health exchange that even might have my GI as an excepted provider and at least one out of the two lists remicade as not covered and the other is UnitedHealth so Im probably in Dale's position with that one. It only covers lialda and meds in that class.
Life just got real

lets all hope I can come up with something cause this is all thats separating me having another PE or obstruction should i have another flare

Don't discount a plan just because of the company and make sure you research the actual plan. I am currently with United Healthcare and all biologics have been covered. However someone in my family was previously with United and had a very restrictive plan. So it's important to know the actual plan you are getting more than the carrier because each carrier has so many different plans available. Just might depend what plans they have in your state.