First it's important to know that here in the U.S. the pharmaceutical industry overcharges terribly and plays an giant shell game with insurance companies. My Remicade infusions cost $26,000 per dose. Because of the high price, many patients here decide not to take Remicade because it's too expensive, so Remicade started a program where they the patient's portion just so they can collect from the patient's insurance company. Otherwise they get would $0.
In the US, this program (Janssen CarePath) will pay all but $5 of the patient's share, but only IF you have private insurance. So figuring out your insurance provider here in the U.S. will be key. You may pay more for private insurance but it will ultimately cost much less over 4 years of infusions.
I would first figure out what hospital you would get your infusions in in California. If there's a university hospital in your new city, that would probably be your best bet. Then contact them and ask for a referral to a social worker or someone in patient services. Tell them you need to talk to someone who handles patients getting Remicade infusions.
Also, in terms of what your student health plan representative told you, that doesn't sound right to me. Make sure the $250 is total coverage. It might be the out-of-pocket amount, meaning once you have reached $250, you don't have to pay anything anymore. For example, my insurance company's private insurance has a $1,500 out-of-pocket charge, and I pay a certain percentage of medical costs (called a co-pay) until then. Before I got Janssen CarePath, my co-pay per infusion was $800, and I reached the out-of-pocket cost after the second dose, so everything was free after that for the rest of the year. The out-of-pocket cost also applies to all other medical costs for the rest of the year,not just Remicade.
The other thing you have to find out is if the student health service is connected with private insurance. If it's public, you can't get the almost-free Remicade. There are private insurance companies in the U.S. that specialize in policies for college students.
If you can't get insurance without putting out a lot of money, Callum, it might be cheaper for you to fly home for your infusions. If you timed it right and got an infusion just before leaving the U.K. and scheduled another appointment for right after the end of the spring semester, your flights home during the academic year would be cheaper than a single infusion. I don't know how often you get your infusions, but perhaps your doctor can adjust it to a higher dose less frequently. For example, I tolerate Remicade well and get a high dose once every two months.
Hope that helps. Welcome to American health care!
