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Becktoria - Re: Reimbursement of Humira

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Posted 10/19/2010 2:56 PM (GMT 0)
Becktoria, in an earlier post you mentioned that you submit the remaining 20% of your Humira cost to a "local government plan." I was wondering what that plan is? I am also in Canada and my drug plan covers 90% of my Humira, but the remaining 10% is still 3k a year (I'm on a weekly dose). I am looking into my options and would be interested in finding out if I am eligible for a similar plan.

Thank you for any information you can provide.
Posted 10/19/2010 3:02 PM (GMT 0)
I am in the Territories... Are you in a Province? I had to submit a doctor-completed form to the Territorial Health Insurance Plan for Extended Health Care Benefits. Apparently proof of income is not required, you just need a dr to complete the form showing you live with chronic and debilitating illness. Crohns is on the list of qualifying illnesses. Then you submit receipts for anything your work plan will not cover. In fact if you dont have a work plan it will cover 100%. I haven't heard back from them yet so I am not sure if there will be problems. It is my understanding that the provinces also have similar plans, but I don't have any info on them. The Humira case manager I was assigned offerred to seek out the remaining 20% reimbursement for me as well- don't you have a Humira contact through Progress? If not, maybe you should call the Progress line and request someone- they apparently are able to seek out further cost reimbursement for patients like us. If you need the # let me know.

Hope this helps.

B
Posted 10/20/2010 2:24 PM (GMT 0)
Thank you for the response, Becktoria! I'll poke around and see if we have anything similar in Ontario. We have something called the "Trillium" program but the last time I checked, it only applies if your household income is below a certain amount (which my 'household' is not).

The Humira people are kind and were initially covering the full extra cost, but recently told me that they made a mistake and I'm actually not eligible. I've been arguing with them for a while now, trying to get across that it's deceitful to cover someone's medication initially and then take away their support now that I'm essentially dependent on the medicine.

I will continue my fight with the Humira support people, and I'll look around for a similar program in Ontario. Thanks again for the response. :)
Posted 10/20/2010 2:41 PM (GMT 0)
Okay well good luck with it! I spoke with my plan today and they confirmed that income does not matter- the only qualifiers are being a resident of the Territory and having a chronic illness confirmed by a dr. So it looks like I can get the 100% coverage (although I have to submit receipts and play the waiting game and probably pay some interest in visa) eventually.

Best of luck

B
Posted 10/20/2010 7:23 PM (GMT 0)
Maybe I'll just have to move to Whitehorse or something. :)
Posted 10/20/2010 7:24 PM (GMT 0)
I heard it's nice ;)
Posted 10/21/2010 1:51 AM (GMT 0)
well, on the plus side, paying for it up front, you'll be able to rack enough travel points to go to Hawaii or somewhere in no time!!
Posted 10/21/2010 3:16 AM (GMT 0)
yep- I put it on the aerogold card for that purpose.... Unfortunatekly I won't use the points for exotic getaways.... probably just trips out of the north to Ontario or Newfoundland ;)

B
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