Question - Insurance companies that cover Remicade

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Hi all,

This post is mostly directed to Canadian users, but anyone that might have knowledge on this subject feel free to reply.

I currently live in Portugal. Here, Remicade is supported by our government health care entirely.

I'm planning to move to Canada, but being a Crohn's patient I'm very worried about my health once there...

I'm getting lots of information wherever I can get it, but can't seem to find the following answers to my doubts:

  • Do insurance companies cover Remicade?
  • Does the government also covers this?
  • What is the best approach for an imigrant to request the support for Crohn's Disease?
  • In an insurance plan, what might be the average cost to pay to have this covered? yearly?

Any guidance here would be very appreciated.

Thanks,
Nuno
 
I have benefits through work and they use Manulife. I had no problems getting covered.

I am in Alberta, if you don't have coverage through work,they have you make application to the government to be covered through a group Blue Cross policy.

There doesn't seem to be any "pre-existing condition so we won't cover it issues" that I have heard of.

I have no idea what you need to do as an immigrant to request support for your disease. Ask the immigration officer dealing with your application for any resources they might know of.

My work benefits(medical and dental and glasses) cost me $250 per month for the family rate- it comes directly of my cheque so I don't even miss it.
 
When I took Remicade, the infusions were around $2,000 an infusion & if I remember correctly, we had to pay out of pocket for the first infusion but after the purchase they reimbursed my parents the $2,000. After that, we enrolled in the RemiStart Program & that helped pay for a lot of the infusions along with our great insurance. I still think it was about $100-$200 we had to pay out of pocket, copay wise.

If you live in the US I would look into RemiStart! Not sure if it's offered elsewhere. I know of many who use it & my GI reccomends it to all his patients.
 
I was on Remicade and Blue Cross Non Group will cover you for $25,000 in medical expenses per year that includes having a pre-existing condition. That was the only plan I could find that would cover pre-existing conditions
 
Not sure how it worlks for immigrants coming to Canada and getting into the Gouverment plan. I think you need to be a full time resident and or have a private coverage. I could be wrong But I certainly would look it up befroe getting on a plane. The medication for me in Quebec is a bit over 4000 a shot. Which is covered through my wife and my own work inssurance.

Good luck
 
Hi Neighbor,

I am in simillar, but opposite situation. I live in America and am considering moving to Portugal for work. Do you have any experience or knowledge on whether Pentasa is covered by the national health insurance? I would likely be supplementing coverage with private insurance, but the prescription benefits for those plans are very minor.

Thanks!
 
I have been on Remicade for a year and in that time just recently switched jobs. I have two companies that cover Remicade that I can vouch for. IBX (Independence Blue Cross Keystone) and Cigna. Though IBX needed me to get pre-authorized. Both had copay of $30 for dr visit infusion and no co-pay on the drug itself.
 
I live in America and was put on Remicade last Feb. while I was in the hospital, because I was there for so long my out of pocket was covered for the year. When 2013 rolled around I knew I would have to pay my deductible again but was not expecting my GI's office to call me on fri. evening at 4:30 to tell me I would need to bring $2000.00 with me to my app. on Monday morning and I would need to pay a total of $4000.00 for the year. The price was almost $6000.00 every 2 months. I don't have that kind of money, so even though the Remicade put me in remission I can no longer afford it. It has been 3 weeks and so far so good. I hope it stays that way.
 
In Ontario you have to be a Resident of the province and have a provincial health card to get provincial government funding. There doesn't seem to be other requirements but I haven't had to go this route yet so not quite familiar.

Insurance probably varies on whether or not it's covered and some will make you try other drugs first, but if you're already on Remicade, then they may not.

If you have to pay out of pocket it costs ~$1050 per 100mg vial or least that's my estimate calculated from my prescription receipt. Mine is total 3150 per dose but I don't have to pay for it.
 
In live in US anthem blue cross covers 90 percent. There is a higher deuctable if you have preexisting condition. I don't know the exact cost . I was already insured when diag.
 
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