I have new insurance through work.
Just got a call saying the Humeria im on is denied and they say they only cover biosimiars. They say they are basically the same but cheaper (for them).
Should i be worried or just keep injecting myself with whatever random stuff people tell me / require me to?
I was concerned for my Daughters going biosimilar, but on all accounts from what I've been able to take in, biosimilars are exactly the same. Some may disagree, and have reactions, but it could be even down to psychological. Hepefully, you'll have the same success as you did with Humira, you should do well.
My large govt. Medical plan switched me from humira to a generic. Due to cost. It was ok , but I developed antibodies and my blood levels of the drug would not stay at the levels my Dr wanted. Then switched to skyrizi.
I switched from Humira to Stelara (after I developed drug antibodies to the humira) and the Stelara was working very well for a few years. I recently had to switch to a biosimilar due to insurance (they didn’t want to cover the Stelara and I switched to Steqeyma) and am now currently having issues (c reactive protein is very high and they’re trying to find out why, not sure if it’s the beginning of a flare or something else)
It’s frustrating to have to switch, or see how sick you can get before you switch back, in general I try to keep myself as healthy as possible outside of Crohn’s stuff and pray for the best.
It’s frustrating to have to switch, or see how sick you can get before you switch back, in general I try to keep myself as healthy as possible outside of Crohn’s stuff and pray for the best.
Im super nervous about switching......and not thrilled about losing all the money. Its only cheaper for the drug company from what i can tell. Humeria had the complete rebate program which made that real affordable until i hit the max out of pocket for the year of 2300. My new plan is 3500+20% coinsurance (scam) until i hit $6000. Basically its taking a 3500 dollar pay cut on top of the new larger premiums. Not thrilled about it but there is nothing else that can be done. I just dont understand how the insurance company can say no...you must use the drugs we say and only from our own pharmacy. Isnt that some sort of conflict of interest? IF they own the drug companies they can just jack up the price on whatever teh drug price is and the 20% coinsurance would acutally be 100% of the drug price either way. You would never know it. Meanwhile they drain your wallet. Thats handy for them. I might have to start looking for a second job on top of my full time gig. Ironically, i am convinced the stress from that is what caused this condition in the first place. Oh well....doesnt really pay to complain. Just get your wallet out and get over it i guess. Maybe i should just be happy i am not forced to pay the full $7k per month the drugs actually cost or that my condition isnt actually worse. I am grateful for that for sure.
Whatever drug you end up with, the drug maker should have a cost help program for low coverage insurance.
Thank you. I didnt think that the generics had that. I will try and look into that. I thought that was only the large name brand ones.
Im terrified they wont cover my upcoming colonosccopy. These are considered routine and preventative and covered but not if you have a pre-existing condition.
I dont understand that either. If im just going on for my routine check every few years to make sure things look good, which i am, then why does it matter if the condition is pre-existing or not? Knock on wood i am completely fine. Its not my choice to go have the procedure done. My doctor says i need to have one every few years though so ....here i am.
I guess id be getting them every few years anyways since that's the new protocol for everyone to screen for cancer and whatever other nightmares down there.
Im terrified they wont cover my upcoming colonosccopy. These are considered routine and preventative and covered but not if you have a pre-existing condition.
I dont understand that either. If im just going on for my routine check every few years to make sure things look good, which i am, then why does it matter if the condition is pre-existing or not? Knock on wood i am completely fine. Its not my choice to go have the procedure done. My doctor says i need to have one every few years though so ....here i am.
I guess id be getting them every few years anyways since that's the new protocol for everyone to screen for cancer and whatever other nightmares down there.