Moving Abroad while on Remicade - South America

[carolined]

Hi! New to this forum but looking for anyone who might have ideas/advice for moving abroad with Crohn's!

I'm from the US and have a moderate case of Crohn's that has been kept really well under control for the past 6 years with Remicade infusions every 7 weeks. In 2016 I studied abroad in Chile and the travel insurance offered through my school covered 100% of my infusions abroad as I was part of a group plan.

Now I am trying to return to Chile for a year or so but really having trouble finding any expat/travel insurance options that will cover me, and have more or less lost hope that there exists any insurance company that would take me on as an individual (as opposed to part of a group plan). I've looked into the in-country healthcare in Chile as well but that seems complicated/I'm not sure they would take me on as a foreigner with a pre-existing condition.

Is there anyone who has had experience moving abroad and receiving infusions? Are there alternatives to travel insurance plans that folks have had success with?

Thanks!!

 

[carolined]

Just wanted to update this thread in case there's anyone like me out there looking for answers to this very specific question --

I did make it back to Chile, without expat insurance... the key was to get a job here and enroll in the public health system, where there is a law called Ley Ricarte Soto which covers 100% of Remicade/infliximab costs for Crohn's patients. This was a very long and involved process, especially because under current conditions it can take over 6 months to receive your temporary residency visa and be allowed to join the public health system. If there's ever someone who wants more information/tips about the process absolutely let me know and I would be happy to help.

Medically though I'm happy to say it's all worked out and I've been receiving my treatments here for 4 months now for very little cost!

 

[kiltubrid]

What did you do about your infusions in the 6 month waiting period?

 

[carolined]

I did a strange and expensive combination of flying back home for infusions, having other people bring me Remicade, and requesting an extra Remicade dose as a "vacation override" and taking it with me to get infused here. The taking Remicade with me thing would probably not be strictly okayed by insurance but the nurses at my US infusion center helped me finagle it. Also since it's against hospital/clinic protocol here (same as US) to just accept random drugs you've brought with you, I had a nurse friend do the infusion (again with the help of nurses from my home clinic loading me up on all the supplies). This was probably risky medically speaking. As you can tell, I was a little desperate.

100% would not recommend, if I were to do it again I would come to Chile to apply for the visa (or maybe even apply for it from the US instead) and then go back to the US to wait the 6 months for my visa to be ready, since legally you can't work until you have it anyways. On the other hand, if I hadn't been here on the ground figuring it all out it may have never happened!

As an additional note, I have been virtually symptom-free for the past 4 years and do nothing else to manage my Crohn's besides my Remicade infusions, so in that sense I didn't have to worry about a lot of other medical/daily life complications that I know others face.

 

[kiltubrid]

I lived in South America (Ecuador) pre-diagnosis, and never felt better health-wise than when I was living there. Lifelong allergies & asthma just disappeared. I was high in the Andes with virtually no pollution or humidity and all the food was natural foods so I'm not sure how much that played into it. I would love to return there permanently some day but Crohn's keeps me near my doctors in the US

 

[jezyg]

Hi carolined

I saw your experience in Chile and was wondering if you could share the details of the person you used to infuse your medication that you brought from home?

I am going to be travelling in Latin America for 8 months and am looking for someone/somewhere in Santiago (or anywhere else in Latin America) that can infuse my infliximab (which I will bring from home - Australia).

Thanks so much in advance for your help!

 

[wickhams]

Hi carolined

I saw your experience in Chile and was wondering if you could share the details of the person you used to infuse your medication that you brought from home?

I am going to be travelling in Latin America for 8 months and am looking for someone/somewhere in Santiago (or anywhere else in Latin America) that can infuse my infliximab (which I will bring from home - Australia).

Thanks so much in advance for your help!

Hi! I'm also from Australia on infliximab infusions every 8 weeks heading to Latin America (primarily South) for 5 months starting soon.
I'd love to know how you went with your planning?
I'm looking into getting an infusion in Brazil and am finding that I need to do a consultation with a registered doctor there beforehand.
Appreciate any guidance!

 

[carolined]

Hi! I'm also from Australia on infliximab infusions every 8 weeks heading to Latin America (primarily South) for 5 months starting soon.
I'd love to know how you went with your planning?
I'm looking into getting an infusion in Brazil and am finding that I need to do a consultation with a registered doctor there beforehand.
Appreciate any guidance!

Hi wickhams,
I'm sorry I did not see jezyg's message when it was posted, but I will try to reply to them and to you in case it's helpful!

The nurse who did my infusions outside of a clinical setting was a friend of a friend and I'm not sure she would be comfortable with me sharing her contact info, but at least in Santiago I often see nurses advertising home services like coming to give you a shot at home (for example here you can buy a flu shot at a pharmacy but then you need someone to actually inject you). If you have your medication and all the necessary supplies with you I think you could find someone who would do your infusion, it might take a couple tries because some nurses might be wary of infusing biologics rather than something simpler like a shot, but if you have been on infliximab for a while and never had a reaction you could probably convince someone.

If you are not bringing your own medication with you and are looking to pay out-of-pocket for an infliximab infusion at a local hospital, I know at least in Santiago if you are not a Chilean resident it could be quite expensive (the full cost of the visit plus the cost of infliximab). And yes, you would likely have to see a local gastroenterologist first to get an order for the medication before you could schedule an infusion.

I can't speak to Brazil or other Latin American countries' systems unfortunately.