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Remicade .. Finances .. Help?!

J

Jenamonkey

Hi,

I was diagnosed with Crohn's last November, and since then have tried Asacol,Pentasa,Entocort and Prednisone. I'm currently on 30mg of Pred and 4000mg of Pentasa a day. It's helping some but I still have a lot of gut pain and fatigue. I don't really have much D and I definitely have never had a prob being underweight. My main symptoms are the pain and pretty debillitating fatigure. My doc has been pushing me to get on Remicade and the insurance finally came back saying they'd cover it. The only problem is that it will cost over $1100 a treatment until I meet a 5K max out of pocket. I just can't imagine going into into this amount of debt for something that may or may not work for me and that I might reject after the 1,2,3,whatever treatment.

The doctor's office did tell me about the RemiStart refund program, but I have no idea if I'll qualify. I'm the breadwinner in the family and my salary usually disqualifies me from any assistance, all of which goes to supporting a family of 2 +stepchild expenses. My husband is currently in college full time and working full time (he was laid off 2 years ago and since then has worked retail. Not great money but he's working hard and I'm proud of him) We've minimized our expenses are much as possible and sold as much as we could. There just isn't room in our budget right now for an extra $5000. Even if the doctor's office will let us make payments, I don't know when or how we'll be able to pay it off. I am pretty sure they won't let me send in $5 a month until it's settled.

Is there anyone else out there dealing with anything similar? Has anyone had any similar experiences dealing with insurance and Remicade coverage? Should I try Humira first (I don't even know if that would be any more affordable). Really, any help or advice is appreciated. I have had a really hard time accepting the fact that I have a chronic disease. I get it intellectually, but emotionally I just want to curl up into a little ball and cry. Now with the insurance telling me "GREAT NEWS!! We'll cover your treatments 100%. Except for your co-pay and this little 30% of the drugs" I'm pretty disheartened. Has anyone gotten assistance from the Remistart program?

Thanks for listening.

Jenn
 
Starla86

Starla86

Don't get discouraged. Apply for remistart its really simple and if you call them they will talk with you and see if you qualify. I have remistart and it helps so much. Between what's left that I have to pay and all my other medical bills I can only manage about 20$ a month to send in. If have to 5$ it to death then do it bc the first time that they say they won't accept a payment you get that in writing and then your balance becomes null and void. I ran into this before. You can only do so much so don't let it get you down. I
promise your family rather pay the money now then watch you suffer the consequences
later. But saying that you need to do what is right for you and your family. I wish you the
best buy definately look into remistart before you rule it out completely. Good luck and I
wish you the best:)
 
S

Saphira

Actually Entocort was our road to poverty, (There is a facebook page named that!). We have a $7000 deductable and after the colonoscopy Brandon was put on Entocort that cost us $1100 a month. The hospital hadn't filed the insurance yet, so at the pharmacy I had to part with $1100 on the credit card to get the meds. The hospital has since filed so we owe various people $7000. We are now on Remicade and luckily covered 100% until the next calendar year rolls around and we have to find $7000 again then. I'm hoping to do Remistart then if it's still working.

Also we are signing up for copayrelief.org It took several mmonths of trying to be accepted, now we are just waiting for our current Doc to confirm the CD diagnosis. (This could be a problem, as the first DOc was the one that diagnosed it, this one says IBD. Copay relief doesn't cover IBD just CD.

Trina
 
J

Jenamonkey

Thanks for theresponses! I faxed in my RemiStart app this afternoon and tried to apply for the copayment assistance (I'd never even heard of that!) I really appreciate y'all responding. Just makes it easier to talk to someone who's in the same place.

Do either of you know the odds that te Remicade will actually work? I know there are no guarantees but it'd be nice to hear it's worth it from someone who's actively taking it.
 
J

Jenamonkey

Thanks for the numbers Saphira. Those are good odds. I think I'm going to schedule my first appt and just hope that one of the assistance programs comes through eventually.

PS I cannot believe the entocort was that expensive!
 
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