So, I thought I did things right. I have a new job (that I got mainy so I can have benefits and get off my fathers insurance, so I don't have to feel guilty for being alive anymore, as he would remind me constantly how I am costing him 600 dollars a month) and the new insurance finally kicked in a month or two ago.
I looked into things, but of course insurance never seems to be able to tell you how much things cost before you do it, they only like to tell you after. But I got a basic understanding that I have a stupid coinsurance of 10 percent so since remicade is around 2800 dollars, Ill be paying 280 per infusion, plus my deductible the first time (a lot more than when I was on my father's, where I pay zero for it...I guess I didn't realize how fortunate I was on that plan...)
The specialty pharmacy people tell me it's 550 the first time, 280 each additional time. I get the infusion after working out a plan with my dad where he'll pay part of it, and I'll pay part of it (I'm a poor broke 20 something who lives in my moms basement, has tons of student loans from a masters in education that is essentially useless since there are no teaching jobs, just keeps me 50 grand in debt). The bill comes for the full 2800 dollars. I prematurely flip out. Turns out there's a preexisting clause (which I'll still never understand...why would I need Remicade if I didn't have a preexisting condition?!) but is easily solved if I get a letter of credible coverage from the old insurance.
I fax it over. Never went through. Turns out their fax just happened to be messed up that day so they give me a new fax number this morning.
But now I'm learning, I got an eplanation of benefits in the mail from the insurance for 600 dollars from the people administering the infusion, i.e. my doctors. So NOW I have to worry about the cost of the Remicade, the 280 (once it gets straightenedout) PLUS cost of place that does infusion....And of course the insurance lady on the phone can't tell me how much it would be. I need to wait til the claim gets straightened out. So I have no idea how much of that 600 dollars I'll need to pay.
I feel stuck. I would want to just stop this medication all together. I dont want to be unappreciate because yes, I am lightyears ahead from where I was one year ago when I was sick and dying, hair falling out, body too weak to even get up from a chair. So yes. I am a productive member of society. But still not at 100 percent. Im still in pain everyday and have bathroom issues everyday. But I feel like the decision is not my own, because though I am nearly 27, the fact of the matter is, I live in my mom and stepdad's basement and I feel like I have to do what they want in this type of situation. I was debating being a lab rat when my father said he might not pay for any of the remicade, and my mom starts crying. I get it. She was there when I was really bad. But who knows? The lab rat clinical trial stuff could work too. It's a gamble. I know it's not good to gamble with your life, but this insurance money crap is stressing me out so much, and that can't really be good for me either.
And I know there are reimbursement programs, but either way, you still need to front the money. And you need to resubmit everytime. And they seem like they will basically have you jump through 1000 hoops so you give up before you get any sort of reimbursement.
I'm strong enough to handle the crohns and the physical pain, who knew I wouldn't be strong enough to handle the emotional and stress side of it all?