Posted 7/5/2017 10:38 PM (GMT -6)
I started Remicade little over 5 years ago. I used to have it done at the hospital with no insurance issues. But than switched to a cancer infusion center because I moved and it was closer. Even tho it's an infusion center it's still attached to the hospital and once again no insurance issues. I than received a letter from the insurance company that I now have to have it done at an ambulatory infusion center, at a doctor's office or at home. Due to cost issues.
I had my Remicade today and talked to the coordinator and she said that most insurances are doing this now and if it's a medical necessity they will allow infusions done in hospitals but the GI doc has to appeal it.
I called my GI's office today and they are going to set me up at an ambulatory infusion center. But here's my problem....when I moved and requested a center closer to me, my GI was adamant about me being infused with a full staff hospital unit. I had a bad reaction after my 3rd infusion and now require pre-meds of Benedryl and Solumedrol not to mention that body was chaotic and I needed close monitoring due to my past BP spikes, breathlessness and chest pain.
I haven't had an issue in 2 years tho - so my question is...should I just see how I do at the ambulatory infusion center or demand my GI appeal? I don't know what to do.