Care and infusions while in college

Hi:


I have a family member who (thankfully) is stable and doing well on Remicade. She has a great doctor and a nice infusion center in Baltimore. However, she is considering going to college in upstate New York and we're getting conflicting information on how it works. In this situation, does a patient usually leave her established doctor (even if temporarily) and have to have a new doctor in the school location? - whether with the school health service or elsewhere? Most small colleges particularly are unlikely to have IBD specialists. I'm also thinking for insurance purposes, e.g. for prescribing an infusion - can a "home" doctor just FAX infusion orders to a remote center? Like I said, getting confusing info and any clarification would be appreciated. Thanks

If your relative transfers schools and transfers insurance, then they will have to find a new GI in the area of their new school. If they are young enough to stay on their parents' insurance, they can keep their old GI. My buddy with Crohns who was younger than me stayed on his parents' insurance for a time, but he would routinely drive all the way back to Maryland to see his doctor there, which I thought was silly. Eventually, he had to go through the process of transferring care over to a new GI in Buffalo as well, but he resisted doing it for a long time, which seemed silly to me.
Right before I moved to Buffalo, NY, I had my infusion at my usual clinic. I had everything ready to transfer insurance over to a new GI in Buffalo. Despite my best efforts, it still took 2 months to get everything sorted out there, and I was freaking out because my Remicade was overdue by 2 weeks. The doctors in Buffalo wouldn't accept any of my medical records from me and insisted on receiving everything by my doctor's office, but a lot of it got lost in the mail.
I couldn't focus on school because I was too busy worrying about my insurance and new doctor. When I finally got a new GI, he wouldn't approve Remicade for me in Buffalo until I had shown him proof a negative TB test, negative Hepatitis test, and blood test results from a blood draw. It seemed to be a neverending process, but in the end, it was all done and I never had any problems in the 4 years I lived there. I can say that my quality of care was excellent.
When I moved down here to Texas, I was still under my insurance in Buffalo. Before my new insurance could kick in, I had to fly from Texas to Buffalo to get my last infusion, even though I had relocated everything here. Having to navigate the nightmares of insurance and access to Remicade infusions is just one of the many joys of having Crohns, and the sooner your relative manages to advocate for themselves, the better off they'll be because they'll have to do it for the rest of their lives.

To echo the others, they should find a GI in the college's area (not at the university, as they typically only have primary care docs), at the very least for emergencies. The distance makes it a bit of a pain to come back for infusions so I would suggest using that GI for all care while at school. Once they find a GI, they can have copies of all their medical records sent to the new GI to minimize disruptions. I would guess most GI offices have at least one doctor who is well-versed in IBDs, and infusions can always be done at a local hospital if the GI doesn't do them in-house.

Of course, a lot of the small details will depend on the family's health insurance plan. I know that most university health plans for students require students see a university doctor first and then get referrals.