Orencia infusion scheduled. | Arthritis Information

 

Got back from Boston, Orencia is scheduled.  I called BCBS, they said it's not covered.  I'll call again on Monday to see if I get a different person with a different answer. Debra, I hope things work out with the insurance and you can get relief.  Why did they say it was not covered and what did they offer as far as treatment goes?  My motto is "If the answer is no, you are talking to the wrong person!" Good luck, I hope it turns out ok.

Waddie I'm like you.  I also deal with medical insurance all week long at work.  I know you can call 3 people, and get 3 different answers.  The scary issue; two people said infusion therapy is not covered.  I'm not giving up.  We have a great BCBS PPO so it doesn't make sense to me.  I'll be all over it on Monday.  Thanks for the support!!!!!!!!!Good Luck! Good luck to you with Orencia.  I hope it works wonders for you.  Dealing with insurance companies is the pits isn't it?  BobKeep calling.  I have BCBS PPO and they pay for it.  Maybe because the Doctors Office didnt code it correctly?  Dont know.  I saw an unpaid bill from my doc and the Orencia is about 00.  Amazing how much it costs.  keep fighting and dont give up!!

 I also had BCBS.  My copay was  0.

Hope you can find a way to make this work.

 

Yikes, 0 every month.....and for loading ,050?

Debrakay, I agree that you should call again, and call the doctor's office (who should be calling the insurance to get this resolved).  I have a BC/BS PPO and mine is covered.  For the infusions I get through the home nursing service, I pay about 0 for dose and service. 

 

Worst case scenario, if they don't actually cover it, contact BMS (http://www.bmspaf.org/program5.html) for their patient assistance program.

 

Hope it gets resolved quickly and you're able to start feeling better soon.

You need names, dates, etc.  Have your doctor write a letter of medical necessity and have it faxed to the proper department and with the name of the person responsible for making the decision.  Follow up with mailing the letter.  Faxes have a way of getting lost.  Make sure you note conversations, names, and dates.  You may need a paper trail.  Usually the first insurance response is no, then yes with $ restrictions.  Your doctor needs to help out here.  They send letters of necessity routinely, so this won't be something new for them.  Good luck.  Lindy
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