HealingWell
Search Close Search
☰

Uceris ins help

Support Forums
>
Ulcerative Colitis
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 8/22/2013 5:54 AM (GMT 0)
Hi everyone, I recently experienced my first flare. I have been on lialda for about 6 months and doing OK. Dr wrote for Uceris and told me he has had good results w several patients. I have excellus blue cross ins and they require 2 flares and failure on mesalimine before uceris is approved. I was given 3 weeks of samples and dr said he would contact the plan to push the script thru. After a few days I started to feel a little better and by end of 2nd week I was back to normal. Uceris saved me sadly ins refused to approve script and dr was limited on samples. After a week off uceris I was back in full flare up. I went on prednisone and saw improvement but after a week I started to develop severe side effects and stopped the prednisone. I'm desperate to get this medication and I don't have the money to pay cash. Does anyone have any success stories on getting uceris approved after being denied.
Posted 8/22/2013 8:10 AM (GMT 0)
You shouldn't just stop prednisone since it can have bad withdrawal effects.

What did your GI say? Did he want to contact your insurance again?
Posted 8/22/2013 10:34 AM (GMT 0)
The active ingredient is budesonide. Your insurance will almost surely cover this. You can take it orally and rectally. You can have the enemas made at a compounding pharmacy if you're in the States. They're available premade in other countries. This is what I've done for under $100 out of pocket.
Posted 8/22/2013 5:16 PM (GMT 0)
You should read through your insurance policy about prescriptions instead of just taking the insurance company's word. Legally they can't just make things up as they go along, they have to go by what is written in your policy. I also have BC/BS but all policies are different, even among the same insurance companies. If it doesn't say that you have to go through these hoops then they can't legally make you do it. I used to know someone who worked for a health insurance company and they would get bonuses for denying things that were actually covered under the policy. The company figured that even though they would lose several of these things in appeals they would still save millions on the people who gave up without a fight and just took their word for it. Bottom line is it is ridiculous that they won't cover a drug which was of obvious benefit to you when the lower tier drugs didn't do so well.
Posted 8/22/2013 9:22 PM (GMT 0)
yes its expensive and insurance companies are likely dreading paying for it... and will try to avoid it if they can. It didnt help me but it didnt give me pred sides either. And no, you cant sub pred for budesonide... you need to taper pred separately and safely. good luck.
Posted 8/22/2013 9:29 PM (GMT 0)
reading your post again.. basically you need to be an advocate for your own health.. and be aggressive if necessary. It would likely behoove your insurance company to get you into remission rather than let the condition worsen which could reasonably lead to greater costs to them down the road. Get on the phone to them and your doctor and advocate!
Posted 8/22/2013 10:17 PM (GMT 0)
freddy - I was thinking the same thing. Sometimes these companies don't see the forest through the trees. It's like not covering birth control pills which is also stupid because just one pregnancy would cost them a whole lot more than covering birth control pills every month.
✚ New Topic ✚ Reply