Is your co-pay realy 20%. I would contact the Remicade people and see what they can do. Any option to change insurance plans and still keep coverage? My co-pay is per infusion and I have 50 units / 500mg every 6 weeks soon to be 4 weeks I think. Last infusion billed Ins. ,452. I think Ins. pays about 85% of that.
This is a disaster. I called the remicaid hotline and 6 different other copay hotlines and NONE of them will cover remicade with the dx of sarcoidosis. I called blue cross directly with the codes and they told me I had to pay 20% of the approved amount, which is .78 each unit. What am I going to do, I can not afford that much. My copays are going to be more than my paychecks!!!!!!!!! My husband is being an ass, I am at work, and can't stop crying. I have already been on all the drugs this is the last resort for me.
I hope someone will join in with another suggestion. Sorry you have to go through this crap!!!I got it from someone's MySpace and they said it worked for them. Actually here is a link to their application in PDF format.
Applying for Assistance
The Patient Assistance Program for REMICADE application is a three-page application. All portions of the application and supporting ..ation must be completed and received in order to determine patient eligibility for the program.
Step 1: Complete Patient Portion. On the application, complete the Patient Information, Insurance Information, and Financial Assessment. Complete all questions and gather the necessary ..ation. Patient or guardian must sign application.
Step 2: Complete Physician Portion. On the application, complete the Physician Information, Prescription Information, and Physician Services. Physician must sign application.
Step 3: Fax or Mail Completed Application. Return the Application to the Patient Assistance Program. Be certain to also submit copies of all required ..ation so that we can review your application promptly.
Applications may be faxed or mailed to:
Patient Assistance Program for REMICADE
PO Box 221709
Charlotte, NC 28222-1709
Fax: (866) 489-5958
Once the application is received:
A program counselor will evaluate the application using pre-established criteria to determine the patient's eligibility for assistance.
If the application is approved, a program counselor will arrange for up to a 6-month supply of REMICADE to be sent to the prescribing physician's office, one treatment at a time.
Continued assistance may be provided to eligible patients who do not have insurance coverage. In this case, applications must be submitted every 6 months.
The program staff will also review applications for assistance to determine if there are appropriate alternate sources of assistance to which patients may be referred.
Patients and physicians may obtain application assistance or additional information by contacting the Patient Assistance Program for REMICADE at (866) 489-5957, Monday through Friday, 8:30 AM to 8:00 PM Eastern time.
Called that remicade number and the pparx and they both said they won't cover for the dx of sarcoidosis. Apparently, its technically not approved for the use in sarcoidosis as of yet. I have a list now of 9 places I have called and no one will help. We make too much for social security or medicaid type benefits. This is one time when I wished I did have ra as they would help me than.
I just can't deal with anymore. My husband, my job, my illness, how did my life get to be such a mess???
Hummm.... is it only Remicade your Dr thinks will help? What about the other Biologicals?I have already been on all the dmards, mtx, enbrel and humira along with over a year of prednisone.
I am sorry, Michele. I hope something else can be done, if you cannot get the Remicade.
Much hugs & prayers!
My sentiments exactly. Good Luck Michelle!Wow..the whole thing sux...maybe you could talk with your doctor? See if they have any other suggestions..try a lower dose and see if it helps first? I dont know...
Oh my gosh, I have called SO many foundations and no one will help me!!!! The good news, if you do have ra and need remicade, there is a lot of assistance available.
I have called an insurance agent and he is researching my blue cross plan and looking to see if he can get me into a better plan that will cover the remicade without such a high copayment.
I haven't had my humira in a month now and feel utterly awful and my hands are so swollen and I hurt, blah, blah, blah. I have to sleep sitting up because the pressure in my chest is too great when I lay down. I can feel the pressure from the granuloma's growing since there has been no medication to stop them for a month now.
I am going ahead with my infusion tomorrow. I may have to sell my soul to pay for it, seriously, I have no idea how we will come up with the money as the budget is already so tight but I can not take feeling so bad any more. Lets hope they can hit a vein.
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