Health insurance provider are in charge!!!

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mdd

Joined
Nov 21, 2013
Messages
107
we changed health insurance provider and now they will not let me get the meds I need for crohn's d I take 800 ml. asacol hd 3 times a day. I called my dr. he said they are in control he could not do anything. now they trying to find meds I could take and they will pay for.It would be 1000.00 for a 3momths supply ouch !!:ymad:. lots of stuff I cannot take. I wonder if others are in the same boat! thanks just venting Love Maria:)
 
Our healthcare is common for the country so that everyone gets treatment at hospitals and doctors offices for a minimum monthly cost, in BC where I am it is $54.00/month for a single person. BC also has a program called fair pharmacare which enables me to get my meds for free after I pay my deductible which is based on my last years income so this year it was $1800 that I had to pay and the province has picked up the cost of everything else (remicade/humira/prednisone etc after the $1800 is paid) I don't have private insurance so that is a blessing. I know that Alberta has a similar program but I'm not sure if the other provinces do or not. Albertan's do not pay health care premiums monthly anymore either. We have Blue Cross here as well that we can subscribe to over and above any private insurance/ and provincial health care that we may have.
 
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How frustrating! I am an American living in Canada and am grateful my husband has additional coverage on top of the provincial health plan. Without it and Humira's drug Assistance program I'm not sure what we would do as our insurance covers 80%. I keep trying to figure out a 5 year plan to get back state side but things like what you are going through make me hesitate. Who makes Asacol? I know both the makers of Remicade & Humira have assistance programs. Does the manufacturer of Asacol have one too? Worth looking into. When my kid was on Remicade they worked with my insurance company to get it all approved and handled everything. It was a blessing!
 
Is there a reason why you are on Asacol while you have Crohn's? It is a treatment which has been shown to be in most cases ineffective, rather the standard long term treatment is immunosuppresives or biologics or a combination.

I am not saying costs should dictate treatment, but e.g. azathioprine (immunosuppresive) costs next to nothing these days, 20 bucks for a month. And considering it is the preferred long term treatment for mild to mid-severe Crohn's, I wonder why any doctor actually prescribes Asacol or Pentasa for Crohn's any more (it works for UC tough, but hardly at all for Crohn's).
 
How are you guys in Canada doing with healthcare?

Ontario's got great medical coverage. We pay nothing; at least I've never paid. We do get taxed pretty good. We also have the Trillium Drug Plan that anyone can use. It kicked in after regular employer benefits or in the abcesnts of benefits. Your deductible is based on income.

I read stories hear and am so greatful for what I've got.
 
How frustrating! I am an American living in Canada and am grateful my husband has additional coverage on top of the provincial health plan. Without it and Humira's drug Assistance program I'm not sure what we would do as our insurance covers 80%. I keep trying to figure out a 5 year plan to get back state side but things like what you are going through make me hesitate. Who makes Asacol? I know both the makers of Remicade & Humira have assistance programs. Does the manufacturer of Asacol have one too? Worth looking into. When my kid was on Remicade they worked with my insurance company to get it all approved and handled everything. It was a blessing!

Have you looked into the Trillium Drug Plan? You can get the forms at any Shoppers Drug Mart or Service Ontario.
 
I have been on asacol for 10 years and it works for me 3 times aday i am in total remission. Im alergic to lots of meds. I got a call from my dr. And he is going over the meds list that the insurance will alou me to have that they will Pay! They in control!! Sad:( this does not help our Stress!,,, just venting! Love you guys :) Maria
 
That's so rough when insurance companies do that. I had a similar situation when I first found out I had Crohn's. My doctor put me on Pentasa and I couldn't afford it. The insurance company I had wouldn't pay for it. So I contacted the pharmaceutical company that manufactures Pentasa. They said if I sent them proof of income they would either discount it or provide it for free.

They ended up giving it to me for free. If you can verify income and monthly expenses, you may be able to get some help that way. Hope this helps.
 
dJW so far we haven't needed the trillium plan. Almost applied when on Remicade as they were helping me with the paperwork but once my daughter went off it &Humira picked up the 20% there was no need. Hope to continue to manage it. Out of pocket I spend less than $400 a year so I can't complain.
 

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