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New insurance Aenta from BCBS, worried about Remicade coverage

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Ulcerative Colitis
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Posted 10/9/2013 11:40 AM (GMT -7)
So I found out on the down low at work that next year we will be changing from BCBS to Aenta and if Remicade is not covered I am going to freak out!!!!!  I can't ask anyone yet b/c I'm not supposed to know.  Anyone know how insurance or Aetna works?  Crikey!  I had to jump through hoops for BCBS! 

 

Posted 10/9/2013 11:42 AM (GMT -7)
so I looked online and found that Aenta does include remicade but I think it's up to the company plan?

http://www.aetna.com/cpb/medical/data/300_399/0341.html
Posted 10/9/2013 12:29 PM (GMT -7)
From reading that link it seems that you are fine. They deem it "necessary" for moderate to severe active UC.
Posted 10/9/2013 12:40 PM (GMT -7)
Aetna has a lot of different policies. I do know they covered my Remicade in the past.
Posted 10/9/2013 12:49 PM (GMT -7)
Thanks, I feel better........mini freak out over!
Posted 10/9/2013 8:08 PM (GMT -7)
Beth,

The new health reform law requires that all insurance policy's pharmacy formularies cover certain types of typical medications for all conditions, a medicine like Remicade should be covered but that doesn't mean it will be cheap.

Fortunately most of these biological patient assistant programs are really good and they will cover you for almost everything; I think my out of pocket for Humira was $30 and Simponi might have only been $5. The drug companies and my insurance company paid the rest.

With Remicade you have a few different options on where to get the infusion, either at your GI's office, infusion center, or hospital; you may want to ask your new insurance company where your co-pay will be the least expensive.
Posted 10/9/2013 8:16 PM (GMT -7)
I've had Aetna in the past and their policies seemed quite standard. No worse than anything else. I've had bad cigna plans and amazing ones. All companies offer a range of plans.
Posted 10/9/2013 10:33 PM (GMT -7)
I don't think that Aetna would be worse than BCBS; in my area the best-regarded medical providers seem to prefer its insurees. Apart from the insurance worry, how are you feeling? / Old Hat (33 yrs with left-sided UC; presently in remission taking brandname Colazal)
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