I had something like that happen to me when I first started Remicade- my GI's office has a woman who handles all the insurance approvals & ppwk for Remicade, & they set everything up, said they had all the necessary approvals, & my first infusion was within a few days. about
2 days before the infusion I get a phone call from Access One, the ppl. who do the RemiStart program- they tell me they're calling on behalf of Dr. blah-blah, my GI, & that because I'm not getting my infusion at my doctors office, it wouldn't be covered, that I had to order the drug from 2 specific pharmacies, & unless the hospital I was going to used those pharmacies, I'd have to pay the full cost, etc, etc.... which was around $10,000! I freak out- to me, Remicade was my last great hope, it was that or surgery, & I was assured everything was all set by my GI's office. I call the hospital infusion center, asking them where they get the drug from, they use their in-house pharmacy, blah, blah... They tell me to call the Access One ppl. back & tell them that they can get the drug from whomever they please. Finally, I get a hold of the Access One ppl. again, totally upset & confused- & they tell me "Oh we made a mistake, the hospital you're using is in your network, so you're fine, everything is covered in full". I was PISSED....... and I let them know it too! They were apologetic, but still.... I've been on the drug for over 2 years now, & haven't heard a peep out of them or my insurer. I think they use scare tactics, to try & get ppl. to unwittingly enroll in their programs. My GI's office knew nothing about
it, by the way.
diagnosed with UC '02
Asacol- 8 tabs/day
Remicade-10mgs/kg- since 4/07