Kickas.org Forums Treatments, Drugs and Alternatives Anti TNF and other biological medications Remicade reactions?

Thanks Tim. I will let you know as soon as I hear from something from my dr's office. I am a little aggravated after days of fretting and then to come to the decision to have this kind of "put off". I will be calling again tomorrow a.m. and if I get put off by the Office Mgr. again I will write the dr. a letter. I don't think he would ever get a message to call me.

Thanks a lot
Blessings.
Possi

I had a sever allergic reaction to Remicade. Tried to take it several times but couldn't.But I had an allergic reaction to every biological treatment. They say that a mild allergic reaction is the most common and not dangerous.

Possi, what happened with your doctor? Did he get back to you? I do hope it works out, as it sounds like your insurance really is trying to help you.

I didn't find out that Remicade is a prescription until I got to the hospital for my first infusion. THAT'S when I was told I had to come up with the cash up front ($3,400 per infusion) and submit the receipt to my insurance company. NOBODY thought to mention it. Not my insurance company, not my doctor's assistant, nobody. It didn't even occur to me to ask about this, as to my knowledge I was going into the hospital for a procedure, which as far I as knew wouldn't involve me going to the pharmacy first.

And I was in agony (I'd been in flare for over a month), just ready to curl up in a ball somewhere and die, so when I heard this I freaked. I mean freaked. On everybody. The pharmacist. The doctor's assistant, the poor guy at reception. Even Dr. Inman, who looked at my letter of approval from my insurance and was shocked to see no mention in the coverage criteria of this being a prescription drug. He apologized profusely for the mess as his assistant should also have ensured I had all the facts.

It's all worked out, of course. My boss covered that first infusion, my mom has covered the second and my company is prepared to issue payroll advances to cover the remainder of them. When the reimbursement cheques come in, I'll sign them over to whomever I owe for that infusion. I am in the process of trying to arrange a line of credit with my bank, tho, so I don't have to go that route.

Anyway, my story all worked out and I trust that yours will too.

Many hugs,

Hi Kat,
How convenient for them to fail to mention this to you. I can't believe not one person mentioned that you would have to pay, then be reimbursed. HELLO!! I would have freaked too, flare or no flare. I am glad you were able to get things arranged. Sounds like you have several people that care about you, which is a good thing. Anyhow, I just had to reply to your post because I was floored by what you had to go thru. If it isn't the insurance company causing grief, it is the doctor's office or the pharmacy. Again, good grief!
Take care,
Cara
One more thing....Is the insurance company going to reimburse you for the total cost? Or will it be what they think is reasonable and customary?

Hey Cara, since Remicade is a prescription and my benefits cover prescriptions 100%, I have to think they cover the entire cost. I should probably call and find out, but I'm almost afraid to!



OK, I'm calling right now.

Whew!

No co-pay, no deductible and no lifetime maximum. Thanks for the unintended push to check on this Cara. It's quite a relief to know I'll be able to give my boss and Mum the full amount without breaking my bank account completely.

Many hugs,

oh my...dog

i can just see you standing in that office...getting hassled about the money...i'd have worried about
small pieces of body parts and blood on the walls...golly, and you're a little 'high strung' to begin with...
i am so glad for you to have this miracle happen and get the money worked out too.

one nice thing i've noticed in the us...you tell the doctor and the receptionist when you fill out the forms
that you have NO INSURANCE at all, and they work for you not a bean counter...and ask for the big discount
cause doctors never collect what they bill, anyway...and they'll let you walk out of the office and mail you a
bill and still talk you if the bill goes unpaid fourteen, fifteen months...to bad drug stores don't do that.

pu liki
aB

"you're a little 'high strung' to begin with"

Jeeze, Ben, you don't know me at all, now do you.

Thanks Ben. I'm so grateful for the miracle. And getting the money hassles ironed out. But, yeah, blood and body parts all over the hospital. I took no prisoners on this one.

Many hugs,

Not exactly one to answer this since I start mine next week! My infusion nurse today told me that they will give me a Tylenol to stop the headache that I WOULD get without it and they will give me SoluMedrol that will last 24 hours to take care of the itching, etc. Does that answer any questions? She said they "may" give me Benydryl too but the SoluMedrol basically takes care of the side effects.

I guess I will know more next week.
Joyce

My insurance company told me they would be paying 100% if Medicare wasn't my Primary provider. Since they are now it will cost me a bundle. Hardly fair is it? My insurance company tried to get my dr. to bypass Medicare and let their Special Needs dept pay for it but he won't because he isn't supposed to so I guess he is a stand-up moral guy who is costing me a lot of money but doing what is right.
JOyce

Ah jeeze, don't you just love it when someone else stands up their morality all over you? I'm glad you have coverage, tho, and I saw in the other discussion that, while it'll still cost you, at least it's not even a 1/4 the annual cost. So there's that, if nothing else.

Good luck with your first infusion hon. I can't wait to hear about it. Headaches? Really? I've not had one. 'Course, now that I said that 'out loud'....

Hugs,