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Just here...
Regular Member


Date Joined Feb 2006
Total Posts : 110
   Posted 7/1/2008 3:25 PM (GMT -7)   

In March of this year, it had been (or what I had thought it had been) one full year since I was on my new medical insurance. I had a pre-existing clause on my plan, so I couldn't really do ANYTHING that came with my UC and going to the doctors. I never really knew just how sh**y(pun and no pun intended) insurance companies and the medical field could be. When I thought that I had reached my time, I made an appointment with my doctors office to start on Remicade again, because it had been almost two years since I had been on it, and it was the ONLY thing (along with Imuran together) that made me 'normal.' I had the infusion, got all the extra meds, and waited.

A few weeks later, I got a phone call from the doctors office stating that I hadn't in fact waited for my clause to go into effect and now owed them over $4000.00. I freaked out. I found out that my Human Resource Manager at work (who is no longer with us) was wrong on when I signed up and it actually went into effect APRIL rather than March. I was sick. I had already at the time owed my doctors office for past procedures while I was without insurance, making my bill over $7000.00. I fell into a pit of depression. As many of you know, the economic status of us living in the Great Lakes State is less than stellar. The doctors office got VERY rude to me, because they wanted their money. I who lives paycheck to paycheck and can barely afford my medications, was sending them monthly, what I could. They said that it STILL wasn't enough. I lost hope, faith, everything. I pushed my boyfriend of almost 7 years away from me, as he say me through ups and downs, through out the course of having this disease while he had known me (I've been fighting with it, since I was 17!) He's always been there for me, the cramps, the bleeding, the doctors appointments, the 'accidents' everything. I felt like I was being a child, but couldn't control it, I can now only imagine what I put my parents through when I was younger and sicker than I am now! I really am surprised that I didn't cause a divorce. I'm getting off track... I blamed the doctors, stating that they should have again confirmed my insurance prior to the appointment, they blamed me for not knowing my insurance. I blamed them for saying "lets not worry about your insurance now, lets just start you on the drug and we'll work it out later" they blamed their nurse saying that she was new. It was a mess,I was a mess.  Phone calls, emails, letters from the doctors, insurance companies, drug companies, patient assistance programs, and nothing could be done. I went to my parents, who didn't have the answers, I went to church, I prayed, still nothing. The doctors office was trying to get me to send them a letter from my insurance company that said when the clause was up, (for legal reasons, I am sure) and I refused. The nurse got reprimanded and was told she needed to help find a way to help me, along with the manager of the building. I filled out the paperwork and was told by the doctors office one thing, my insurance company another, the assistance program yet another thing.

I gave up hope.

There was nothing anyone could do.

about a week ago, I got a very up lifting call from Judy, the office manager. They found an assistance program that would pay for my last treatment that wasn't covered. It was taking not all, but most of the debt away. Next, I got a call from the nurse to tell me the same thing, and also that I should call RemiStart another patient assistance program and have them re-process my information, I called immediately. They told me that I had qualified back in May and that they would cover what my insurance company wouldn't for my future infusions. They were going to FedEx me all I needed so I can start back on Remicade.

I don't know why I wrote all of this, really I don't. I just wanted to give some sort of hope out there for people out there, who are going through the same thing that I am and most likely will forever, in dealing not with the disease, but the finical burned that it causes. I have always had horrible luck, and this disease is just one way that I know that I always will. Part of me feels that it's still too good to be true. And you know what, it could be. I haven't gotten the bill yet from the doctors office that shows the deducted price. I haven't received the assistance yet, but one thing that this WHOLE thing has taught me, is not to worry. The stress from having to worry about where the closest bathroom, or dealing with the pain is the only stress I am going to let bother me now. I have made myself a promise that I will no longer allow myself to stay up all night worrying about where the money is going to come from to pay for this. The second that I did, something came along.

Have faith, friends, and don't let this horrible thing run your life!


Jared
Pancolitis diagnosed in '99
Crohn's Disease diagnosed in '06
Currently on:
Medrol Dose Pack
Imuran 100 MG Daily
Asacol 1600 MG Daily
Flexeril 10 MG (four times a day for relaxation/stress relief)
Remicade
Slow release Iron
 
 


enjoyingnow
New Member


Date Joined Jun 2008
Total Posts : 8
   Posted 7/1/2008 4:56 PM (GMT -7)   
Just here,
Wow, I really have not even ever had to consider that stress. I live in Canada, and I go see one of the top GI's in the country. It doesn't cost a penny to see him (actually not true I pay $42.00/month for full healthcare), and I have 80% coverage for my meds. I can't even imagine having to go through the stress of having to cough up the cash to go see a specialist. You sure gave me something very positive to thing about going through everything. Someone always has it worst. I can never feel too sorry for myslef!! :)
I'm glad to hear things have worked out.
Take care of yourself!

jayce
Regular Member


Date Joined Nov 2007
Total Posts : 382
   Posted 7/1/2008 4:56 PM (GMT -7)   
hi jared,
i don't know how old you were when you were daignosed, but don't think you almost caused your parents divorce, they probably felt like we do here, and it's not my daughters fault she didn't choose to be sick.
and however the parents react may be something they had to go through and sometimes they just couldn't "deal like adults'.
as far as insurance you seem to be on your toes and waiting two years for a treatment is crazy in this day and age-but it's the world in which we live-i don't get it -not very advanced-but it's always on our minds and we worry if our daughter will be well enough to work when she no longer qualifies under our plan.
good luck and don't believe nothing good happens to you maybe it did this time.
Mom to 19 year old daughter diagnosed 11/07.
colazal 3 x3 daily
purinethol 6mp=50mg daily
culturelle probiotic 1 daily
chewable vitamin
xifaxan antibiotic 400mg 2x day soon to be weaned


bellski
Regular Member


Date Joined Apr 2008
Total Posts : 499
   Posted 7/1/2008 5:32 PM (GMT -7)   
Glad it is working out. I hate insurance sompanies, I thought they were suppose to help us.
Lori (Bellski)-age 43 from Illinois
Diagnosed February 2008 with Ulcerative Proctitis,
Currently: mild symptoms / flare ?
Medications:  Asacol 400mg X 6, Canasa X 2 
Vitamins:  Calcium 600 + D X 2, Centrum, Citrucel caplets, Probiotics
High fiber diet
"I thank God that  I found this website!"
 


Kiss520
Veteran Member


Date Joined Jun 2008
Total Posts : 742
   Posted 7/1/2008 5:43 PM (GMT -7)   
Congrats on your news! I know that any victory feels huge when dealing with this disease, even if it isn't a health-related victory. I'm glad that stress is off your shoulders.
Female, 30.   Chicago 'burbs.
DX:  Ulcerative Proctitis (10cm) January '08
Current Treament:  Rowasa 60 ML 2X daily, Cortenama 100 ML 1X daily, Bentyl 20 MG 4X daily, Fish Oil 2x daily, Disgestive Advantage (Colitis) 2X daily, Metamucil 2X daily, Yoga daily.
Previous Treatment:  Canasa suppositories, Cortifoam, Prednisone, Colazal, Symex DuoTabs, Vitamins.
Status:  Flare (showing some improvement)
 
 


Just here...
Regular Member


Date Joined Feb 2006
Total Posts : 110
   Posted 7/1/2008 6:47 PM (GMT -7)   
Thank you all. I was seventeen when I was diagnosed, I posted another thread that I wrote for college about my ordeal, check it out. It's also on my myspace...

Hopefully there is some good in all of this, and that I will finally get the help that I need. It's been hard to work sometimes, but I am the bread winner in the family (my boyfriend who has a college degree for over six years) doesn't have the best job, so I have to do it. Only once about 3 years ago, did I take short term disability to help reduce the stress, which help, it was when I started on the remicade, and it was a 'cure' for me. I just hope that this all 'sticks' and I'll be able to get back on it, and be 'normal' again!
Jared
Pancolitis diagnosed in '99
Crohn's Disease diagnosed in '06
Currently on:
Medrol Dose Pack
Imuran 100 MG Daily
Asacol 1600 MG Daily
Flexeril 10 MG (four times a day for relaxation/stress relief)
Remicade
Slow release Iron
 
 


jujub
Forum Moderator


Date Joined Mar 2003
Total Posts : 10407
   Posted 7/1/2008 7:30 PM (GMT -7)   
Jared, my insurance requires a yearly preauthorization for Remicade. The doctor's office takes care of that. Once they were late, and I told them I didn't expect to pay them just because they didn't do the right paperwork. They worked it out with the insurance company.

I'm so glad to hear you have insurance coverage again. We certainly can't afford to be without it!
Judy
 
Moderate to severe left-sided UC (21 cm) diagnosed 2001.
Avascular necrosis in both shoulders is my "forever" gift from steroid therapy.
Colazal,  Remicade, Nature's Way Primadophilus Reuteri. In remission since April, 2006.
 
Co-Moderator UC Forum
Please remember to consult your health care provider when making health-related decisions.


Sara14
Veteran Member


Date Joined Mar 2007
Total Posts : 4034
   Posted 7/1/2008 8:23 PM (GMT -7)   
Jared - That must have been such a huge relief for you to find out you won't have to pay all of that back! That's great! I was wondering how your insurance is now covering your UC if you previously had a pre-existing clause on it. I am very scared of losing my insurance at some point and not being covered for UC when I get a new insurance. I also would like to travel and go on a long hike at some point in my life, but I feel like I can't ever do those things for an extended time period b/c I need to work full time so I can keep my insurance.
24 years old
Diagnosed with UC March 2007; yet to go into complete remission
Asacol 4 tablets 3x/day
Rowasa (generic) - nightly; Canasa (1,000 mg) in the morning
Nature's Way Primadophilus Reuteri 2/day; Chewable multivitamin; Metamucil; Viactiv


TraciZ
Regular Member


Date Joined Aug 2007
Total Posts : 255
   Posted 7/2/2008 5:36 AM (GMT -7)   
Thank you, Jared, for sharing that inspirational story and the lessons your experience taught you.
Tressa 35 (F)
probably pancolitis
Colazal 3X3/day, Lialda upped to 4/day,Phosphatidylcholine 4 (420 mg capsules) once/day
Colazal 3X3/day (not generic)
Rowasa & Canasa as needed
Asacol 12/day


Just here...
Regular Member


Date Joined Feb 2006
Total Posts : 110
   Posted 7/2/2008 5:39 PM (GMT -7)   

Sara, I had to wait one year after I had already signed up for my insurance, so one full calendar year.  ANYTHING that related to UC was not covered, doctors apointments, bloodwork, I DID have prescription coverage that covered the Imuran and Asacol.  MAKE SURE THAT YOU KNOW YOUR INSURANCE POLICY VERY WELL!  If you get new, see what the pre-existing clause is, the waiting period, etc.  In the States, it is illegal for an insurance company to deny you full coverage if you get new insurance within I believe, but don't quote me on it, 59 days after your other insurance was over.  Again, the number may be higher or lower, research it, Sara, and let us know.  I can't remember what the days are you have, but once it's up, THEN you're screwed for the time being.

One thing that I miss, is playing soccer and beach volleyball.  I haven't played either since I was like 12 and I can't wait till I can again!

Sara14 said...
Jared - That must have been such a huge relief for you to find out you won't have to pay all of that back! That's great! I was wondering how your insurance is now covering your UC if you previously had a pre-existing clause on it. I am very scared of losing my insurance at some point and not being covered for UC when I get a new insurance. I also would like to travel and go on a long hike at some point in my life, but I feel like I can't ever do those things for an extended time period b/c I need to work full time so I can keep my insurance.


Jared
Pancolitis diagnosed in '99
Crohn's Disease diagnosed in '06
Currently on:
Medrol Dose Pack
Imuran 100 MG Daily
Asacol 1600 MG Daily
Flexeril 10 MG (four times a day for relaxation/stress relief)
Remicade
Slow release Iron
 
 


Sara14
Veteran Member


Date Joined Mar 2007
Total Posts : 4034
   Posted 7/2/2008 7:32 PM (GMT -7)   
Thanks, Jared. I hope you get well enough to play soccor and beach volleyball again very soon!
24 years old
Diagnosed with UC March 2007; yet to go into complete remission
Asacol 4 tablets 3x/day
Rowasa (generic) - nightly; Canasa (1,000 mg) in the morning
Nature's Way Primadophilus Reuteri 2/day; Chewable multivitamin; Metamucil; Viactiv


Just here...
Regular Member


Date Joined Feb 2006
Total Posts : 110
   Posted 7/2/2008 8:12 PM (GMT -7)   
As do I hope that you will get to take that hike!
Jared
Pancolitis diagnosed in '99
Crohn's Disease diagnosed in '06
Currently on:
Medrol Dose Pack
Imuran 100 MG Daily
Asacol 1600 MG Daily
Flexeril 10 MG (four times a day for relaxation/stress relief)
Remicade
Slow release Iron
 
 


Sara14
Veteran Member


Date Joined Mar 2007
Total Posts : 4034
   Posted 7/2/2008 9:29 PM (GMT -7)   
Thanks. =)
24 years old
Diagnosed with UC March 2007; yet to go into complete remission
Asacol 4 tablets 3x/day
Rowasa (generic) - nightly; Canasa (1,000 mg) in the morning
Nature's Way Primadophilus Reuteri 2/day; Chewable multivitamin; Metamucil; Viactiv

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