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Hospital Stay/Started Remicade while there.

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Ulcerative Colitis
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Posted 10/26/2017 6:11 PM (GMT -8)
Was hospitalized on Oct. 20 for a 18 month flare that was not being treated properly by the healthcare professionals.

Anyway it got so bad that I had to be admitted to the Hospital and was put on Remicade.

Well I am home now Thank God, out of pain and starting to feel a bit better. Of course I am still tired.

I am still on the Preds for now.
Posted 10/27/2017 4:16 AM (GMT -8)
Glad you're home and feeling better!

I get it, it's super frustrating to not get the exact treatment you want due to health insurance getting in the way. We've all been there, fighting with insurance companies is like a chronic illness patient's official past time hobby. I know I've spent countless hours calling insurance, doctors, and pharmacies trying to understand delays, and unexpected charges on bills. I just got a bill today $12 for a DEXA scan I had a year ago lol, craziness. We try the best we can to choose the most affordable and cost-effective way to be treated.

Remicade worked well for me and put me into a remission. I hope it works as well for you! Entyvio infusions can be over $15,000.00-18,000.00 or more per infusion, I'd never consider paying out of pocket for them unless you're rich lol.
Posted 10/27/2017 4:35 AM (GMT -8)
There is a payment assistant program for Remicade, you can check it out here:

https://www.remicade.com/plaque-psoriasis/medication-cost-support
Posted 10/27/2017 7:09 AM (GMT -8)

iPoop said...
Glad you're home and feeling better!

I get it, it's super frustrating to not get the exact treatment you want due to health insurance getting in the way. We've all been there, fighting with insurance companies is like a chronic illness patient's official past time hobby. I know I've spent countless hours calling insurance, doctors, and pharmacies trying to understand delays, and unexpected charges on bills. I just got a bill today $12 for a DEXA scan I had a year ago lol, craziness. We try the best we can to choose the most affordable and cost-effective way to be treated.

Remicade worked well for me and put me into a remission. I hope it works as well for you! Entyvio infusions can be over $15,000.00-18,000.00 or more per infusion, I'd never consider paying out of pocket for them unless you're rich lol.

Good Morning iPoop!

Thank you for the positive support. So the good news is we have a plan I got the Remicade and I am feeling better.

Thanks again!

Post Edited (newme22) : 10/30/2017 7:57:45 PM (GMT-6)

Posted 10/27/2017 7:19 AM (GMT -8)

blksteeda said...
There is a payment assistant program for Remicade, you can check it out here:

https://www.remicade.com/plaque-psoriasis/medication-cost-support

Thanks for the heads up blksteeda.

I'll check it out. I checked out a payment assistant program when on Humira but the do not assist with payment for those with VA benefits. May be this one will be different.
Posted 10/27/2017 7:35 AM (GMT -8)
I'm not sure how VA benefits work. But "usually" if your hospital is in network then the insurance company will cover everything even if your doctor or medicine is normally not covered, especially when you go through the ER.

I've been able to get my GI covered when he didn't take insurance because I went through the emergency room, same things with meds. I responsible for only my co-pay.

I fought about the bills for many months but ultimately they were covered.

Again, the VA benefits may be different.
Posted 10/27/2017 9:35 AM (GMT -8)
I think you beef is with you insurance and not the providers.

They don't work for free, and other companies give pre-authorizations, or estimated coverage, or tell if it is in formulary (or requires a necessity appeal). OR if Remicads has to fail before they authorize Entyvio.

If there really is no "gotcha" in the proof of medical necessity, then all the company had to do was say "its covered" when they called. For whatever reason you company did not say "its covered" - the fault is with you company.

That said, I do not understand why they would not let you pay for it. It would likely have cost thousands per treatment, and maybe they did not want to treat and bill only to find you would not pay.
Posted 10/27/2017 10:55 AM (GMT -8)
So sorry to hear about the loss of your husband, it's new to us all here and no one here knew about that, nor was any insult intended. Certainly the VA health insurance process is not something we are all familiar with, don't have many who post questions about it. We certainly all get emotional at times, but lets get back to the subject at hand in your original post smile
Posted 10/27/2017 12:16 PM (GMT -8)

ks1905 said...
I'm not sure how VA benefits work. But "usually" if your hospital is in network then the insurance company will cover everything even if your doctor or medicine is normally not covered, especially when you go through the ER.

I've been able to get my GI covered when he didn't take insurance because I went through the emergency room, same things with meds. I responsible for only my co-pay.

I fought about the bills for many months but ultimately they were covered.

Again, the VA benefits may be different.

Thanks ks1950 for the info.
I will give the ER a try if there is a next time. I hope not though.

Post Edited (newme22) : 10/30/2017 8:00:28 PM (GMT-6)

Posted 10/27/2017 12:39 PM (GMT -8)

iPoop said...
So sorry to hear about the loss of your husband, it's new to us all here and no one here knew about that, nor was any insult intended. Certainly the VA health insurance process is not something we are all familiar with, don't have many who post questions about it. We certainly all get emotional at times, but lets get back to the subject at hand in your original post smile

iPoop,

Thank you for the condolences. It was a great loss.

Post Edited (newme22) : 10/30/2017 8:01:51 PM (GMT-6)

Posted 10/27/2017 2:11 PM (GMT -8)
Just wanted to say thank you for your husband's service and send condolences for your loss. You seem to try to maintain a positive attitude which is remarkable given all you've been through.

Not familiar with VA medical either, but I just want to point out that if you look into Remicade's assistance program, don't give up just because of what it may say on the website. Always call them and ask. I say this because I'm getting a couple of my medications for free from the manufacturers, despite their websites saying they don't offer assistance to Medicare users. They have other, kinda secretive (in that they don't openly advertise this sometimes) assistance programs. Salix is one of the manufacturers that helps me out and they are very kind and helpful on their telephone assistance lines. Never hurts to call and ask. Medicare health programs are great, but the cost sharing on prescriptions can be really high, especially for expensive medications like we take, and there is no out of pocket limit.
Posted 10/27/2017 2:50 PM (GMT -8)

FlowersGal said...
Just wanted to say thank you for your husband's service and send condolences for your loss. You seem to try to maintain a positive attitude which is remarkable given all you've been through.

Not familiar with VA medical either, but I just want to point out that if you look into Remicade's assistance program, don't give up just because of what it may say on the website. Always call them and ask. I say this because I'm getting a couple of my medications for free from the manufacturers, despite their websites saying they don't offer assistance to Medicare users. They have other, kinda secretive (in that they don't openly advertise this sometimes) assistance programs. Salix is one of the manufacturers that helps me out and they are very kind and helpful on their telephone assistance lines. Never hurts to call and ask. Medicare health programs are great, but the cost sharing on prescriptions can be really high, especially for expensive medications like we take, and there is no out of pocket limit.

Hi FlowersGal! Nice to meet you.
Thank you so much for your condolences they are much appreciated. And thank you for the great tips for ways to try to get help with the cost of the medicines. I feel your positive energy and am inspired to give it a try and as always to keep up the good fight for a happy and healthy live again. Wishing you the best and sending positive energy right back to you today.

Post Edited (newme22) : 10/30/2017 9:18:06 PM (GMT-6)

Posted 10/27/2017 5:45 PM (GMT -8)
Be nice DB... this is a support forum.
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