My arther doc shutin my remicade down...

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iVillage Member
Registered: 03-25-2003
My arther doc shutin my remicade down...
17
Sat, 03-12-2005 - 5:52pm
Yep he claims Senior Anthem isn`t reimbursing him enough. Wants us pofolk on senior anthem to go the hosp to have it. Well I`m not sure but I think that would be considered an out pt proceedure. At 250$ a crack this pofolk won`t be able to afford it. I will call anthem first thing Mon to find out. And if it is that much then my arther doc gets a call to put me back on some meds he took me off. You know I have felt so aweful the last few days-wks I was wondering if remicade was working anyway.I am trying my best not to let this stress me cause thats all I need.Thanks for letting me vent twice in one day. Bev

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iVillage Member
Registered: 11-03-2003
Mon, 03-14-2005 - 11:57am
Bev, I am outraged at your doctor!

Molly

iVillage Member
Registered: 03-25-2003
Mon, 03-14-2005 - 12:18pm

(((((((((Bev)))))))))

That is so wrong!!! Did he suggest a replacement med? I can't remember, have you ever tried Enbrel?

It makes me so mad, when we are at the mercy of the insurance companies and doctors.

Hugs,
Vicki

Avatar for beviej
iVillage Member
Registered: 03-25-2003
Mon, 03-14-2005 - 5:09pm
I made all my calls today and the bottom line is NO More Remicade for me!!!I was rite it would cost me 250$ every infusion.Senior Anthem won`t cover Enbrel or humara. And the new script plan I am on has a yearly max so I can`t even consider that.OH WELL! I made an apt to go see the rheumy the 19th of May but if this hurtin doesn`t stop pretty soon I may go in sooner. At the very least I need to be put back on plaq.All I`ve wanted to do today is go roll up in a ball and cry. I`m sorry guys I`m just havin an OH POOR PITYFUL ME party.
iVillage Member
Registered: 03-25-2003
Mon, 03-14-2005 - 5:53pm

((((((((((Bev))))))))))) Are you on anything for the RA? If no, you can not wait till May to see your rheumy! I have never heard of such a thing!! Is he still accepting your insurance? You deserve a good cry and when you are done, come up fighting!!! I hope there is a solution out there and another drug that will help you.

Love, Vicki

iVillage Member
Registered: 08-21-2004
Tue, 03-15-2005 - 4:07am
Oh, I am so sorry. I have written here about my struggle getting ins approval for Remicade and how hard my doc has been working to get it.
Donna
iVillage Member
Registered: 01-16-2005
Tue, 03-15-2005 - 5:22am
I dont have any advice, Im new to all of this. I just wanted to say how sorry I am that you're in such pain and having to deal with all the insurance junk. I hope you get some relief soon.
Avatar for beviej
iVillage Member
Registered: 03-25-2003
Tue, 03-15-2005 - 6:41am
Vicki, I`m on everything....MTX,folic acid,celebrex and predisone. He took me off the plaq after I was on remicade a couple months.I`m thinking I`m in a flare and maybe I need a shot of cortisone in the butt.We`ll see! And I did call my ins com and if Ihave the remicade at the hosp it will be a co pay of 250$ evrytime.NO THANKS TO THAT!
Avatar for beviej
iVillage Member
Registered: 03-25-2003
Tue, 03-15-2005 - 6:45am
(((((((Donna))))))))) Please do not be discouraged because of me. And i am so soryy tomake you feel that way. Everyone of us is different. You must try the remicade. And I so hope it will help you. I do`nt really know that it wasn`t helping me. Maybe when it all wares off I will find out just how much it has been helping me. So you go for it girl!!!!! Hugs Bev
iVillage Member
Registered: 08-21-2004
Tue, 03-15-2005 - 7:28am
I will try it if and when it is approved. My doc's nurse said it will be. Were you taking it for along time and then it stopped helping or did it never help as much as you had hoped? I have heard it does work at first and then not after a while, which is why I am no Imuran, to prevent the antiboties from building up against the Remicade, or something like that.

Donna
Donna
iVillage Member
Registered: 04-08-2004
Tue, 03-15-2005 - 10:42am

Bev, is there another rheumatologist on your approved doctor list? Maybe another doctor would accept the insurance company's payment? In fact, I don't think I would ever want to see your doctor again. If your insurance is covering the cost of the medication and a reasonable fee for the infusion, it is unconscionable to refuse treatment. I know that the doctors charge a very high fee for their infusion "services," and it is a pretty good money-maker for them. That is why some doctors really push Remicade for their patients--it is the only treatment from which they make money. Yes, it is a good treatment for many people, but it is often the first that the doctors want to try because payment comes to them instead of the drug companies--which is another story completely. OKAY--no soap box--I promise. I know when I tried Remicade my doctor kept upping the dosage to no avail, and I called it off because my insurance company was paying out a ton of money and it wasn't doing me a bit of good. I know it was $650 per unit for the Remicade, and we were up to five units, plus $750 to the doctor for the infusion (for 2 hours of chair space plus maybe, at most, 15 minutes of a nurse's time)--and that was several years ago. I'm sure it's more now. I think I'd scout around for another doctor if you have a choice on your insurance plan.

Hope it all works out.

Rosemary

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