How long did it take you to get Remicade pre-authorized by your insurance?

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indigosunrise
Regular Member


Date Joined Nov 2007
Total Posts : 497
   Posted 11/24/2008 5:51 PM (GMT -7)   
I am frustrated.  I was told I would get on Remicade at my last GI appointment,which was a little over two weeks ago.  Anyhow, my GI's office WILL NOT call me back.  I have a feeling the problem isn't so much with my insurance approving Remicade as it is with the GI calling me back.
 
Anyhow, did it take a long time to get Remicade approved for those of you who are on it?
 
Thanks everyone!

Ides
Forum Moderator


Date Joined Nov 2003
Total Posts : 7077
   Posted 11/24/2008 6:00 PM (GMT -7)   
My first authorization was requested on a Thursday afternnon and approved Monday AM. It was from a large west coast PPO.
Moderator Crohn's Disease Forum
CD, Ankylosing Spondylitis, lupus, small fiber peripheral neuropathy, avascular necrosis, peripheral artery disease, degenerative disc disease, and a host of other medical problems.
 


petittarte
Veteran Member


Date Joined Apr 2006
Total Posts : 686
   Posted 11/24/2008 6:40 PM (GMT -7)   
As long as it is done in my GI's office I don't need an authorization and I don't have a co-pay.
Jodi

Remicade and 6MP


patientspiders
Veteran Member


Date Joined Jul 2005
Total Posts : 733
   Posted 11/24/2008 7:31 PM (GMT -7)   
My Remicade got approved in about 48 hours the first time. But, like you noted, that doesn't mean anybody wanted to TELL me. PAH.

Good luck!
27f, dx'd CD July '05 after 6 fistula/abscess surgeries
(miscarried at 13 weeks, now waiting to heal before trying again)
Stopped Humira August 22nd, 2008.
Went Gluten-Free, noticing some definite improvement.
Started LDN October 27th, and already LOVING IT.

"Our greatest fear is not that we are inadequate, but that we are powerful beyond measure."


mkl11
Regular Member


Date Joined Jul 2007
Total Posts : 494
   Posted 11/24/2008 9:18 PM (GMT -7)   
My Remicade was approved within a week. My Humira...well...that took SEVERAL months. The process started in June and I just started the meds in October. Even after I started I was getting letters saying I was denied (?????), so I sympathize with you. Just keep trying!
20 y/o, diagnosed 6/2007. On Humira, no wheat or corn syrup, low sugar, low dairy.


tsitodawg
Veteran Member


Date Joined Sep 2006
Total Posts : 845
   Posted 11/24/2008 11:57 PM (GMT -7)   
My remicade was approved after I was in the hospital for a couple weeks. Most insurance companies want you to have failed on the other medication before they approve the big gun medications like remicade, humira, or cimzia. These medications are very expensive and they are not about to approve them without trying the less expensive ones first or unless you have a severe flare. Have you tried and failed on any of the other medications such as asacol, pentasta, or any other of the 5-asa's?

Kaycie
Regular Member


Date Joined Jan 2006
Total Posts : 449
   Posted 11/25/2008 1:50 AM (GMT -7)   
Approved within a week. And, this was with a difficult insurance company. Basically, after about 2 or 3 infusions each year, the required re-authorization. My new insurance has been fab. They hardly ever ask questions.

Remicade is super expensive, so it might be the hold up, but I'd bet your GI's office is the hold up. Can you maybe just walk in one day and request info? Might be balsy, but might get them on top of things.

Sorry you are struggling. I hope you start the infusions soon. Remicade was a pure blessing to me and I hope I find something to help me again soon!
Kaycie - Age: 26
Crohn's - Dx Nov 05
Failed Remicade, moving onto a Clinical Trial called ABT-874 - Tentative start date - 10/2/08 - 10/16/08  - Infusion, every 4 weeks.
IVF #1 (In-Vitro Fertilization) - Failed
IVF #2 - IVIg, Heparin, Baby Aspirin - TWIN GIRLS!!!
Reagan Dawn - 8/2/07 - Lived 1 hour 27 minutes due to Cloaca, NOT affiliated with my Crohn's
Addison Maria - 8/2/07 - 13 months old


indigosunrise
Regular Member


Date Joined Nov 2007
Total Posts : 497
   Posted 11/26/2008 7:36 AM (GMT -7)   

Thanks so much, everyone!

I called my insurance yesterday morning and they suggested going to my GI's office.  I went there after that and they told me they contacted the out-patient clinic who would call me to get the infusions set up.  Anyhow, the clinic called me last night and I am scheduled for the first infusion today.  :-)    I sure hope this helps!

 

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