Individual Health Insurance Policies and excluded Asacol

Shopping for an individual health insurance policy is proven to be quite a challenge!!

So to add injury to the insult of the pharmaceutical company developing phony copycat patents for Asacol through AsacolHD & now Delzicol the insurance companies do not include these drugs on individual policy formularies!! My UC has remained in remission (for 24 yrs!) on these drugs ... Should I experiment with generic or alternative drugs and risk flaring? Order Canadian? Pay for brand out of pocket (about $5500/yr after rebates)!!

Apriso Canasa Creon PancreaseMT Pancrelipase zenpep uceris viokase specialty(cuvposa enbrel entyvio gattex humira remicade sandostatin somatine depot)
Then generics (balaalazide budesonide glycoprrrolate lipram pangestyne sulfasalzine ursodiol)

The plans are a joke for people with serious medical conditions. I am sorry. I took Apriso and it is fine but i can understand not wanting to rock the boat.

both the pharmaceutical & insurance companies lack compassion for chronically ill - and what big pharma would research for a cure .... definitely a conflict of interest

I've had large deductible plan under my husband's employer for several years so my pocketbook has been abused for awhile but now need an individual plan (husband is going on Medicare) I have to gamble on a different Rx - when I'm certain asacol keeps me in remission ! This is absurd. The drug companies are legal drug dealers and nothing more - I lack respect for them completely! Insurance companies aren't much better but are probably just reacting to the pharma company patent abuse. It should be criminal to hold us hostage to these patented drugs. When is someone going to expose them to get our politicians to do something about this (or are they in their back pockets to boot?!)

iPoop said...
If you have the option of a better health insurance policy then go for it. High deductible plans are horrible for the chronically ill, like us. I like Cadillac-plans much better.

There really aren't any great plans anymore. I looked at the plans offered through obamacare, you're either paying $6000 deductible and $150 a month. Or you pay $300 a month and you pay 30%+ copay up to $6000. For people like us, it means you spending about $200 a month + $6000 + whatever else isn't included.

The only good plans come from being part of a group. Maybe you can go direct to the insurance companies and pay more for a decent plan but covered california was very limited and they were all pretty much the same when you break it down. A lot are HMO too so you spend all that money and you can't even choose what doctor you want to see, you have to get all those stupid referrals. Such an awful rip-off.

The part that is really crazy is that being insured, often you're not eligible for patient assistance programs. I wonder if they are even offered anymore. I used to get Asacol for free from P&G. They would send me 3 months at a time in a sealed envelope for nothing. I bet those companies love not having to do that anymore. Copay assist programs have to be much less costly for them than PAP. I am convinced all this has helped insurance and pharma companies more than people. The only + is that preexisting conditions can get coverage but the coverage is unaffordable.

I have a group plan but i was looking at the plans for my SO. Actually, now that you mention it, that is how they are bronze, silver, gold or platinum. I didn't find that the platinum plans were even all that good. I guess I probably didn't inspect them fully because he didn't want to spend the maximum. He is healthy so he doesn't care that much. Just seemed like everything was very expensive. There were charges for everything + the monthly costs were high. The max out of pocket were high. copays high... i am thankful I have a job with decent coverage. I am still spending an arm and a leg, but hopefully after all is said and done I can stop spending so much on healthcare.

Sometimes a switch from one brand of meslamine medication to another brand of meslamine medication is inconsequential. Other times, it can cause troubles, sometimes even causing a flare. Each brand has a different ph-based delayed-release coating that results in different medication release points in the large intestine and different distribution rates. Depending on your ph level, it might release to soon, or not release at all.

Balsalazide (colazal) and sulfasalzine are also on your formulary list and do not have a delayed-release, coating. Rather they're a compound that's broken down into meslamine by gut bacteria.

Many switch successfully you can however appeal to insurance or have your doctor appeal. Sometimes when they take to Twitter it helps ( dr David Rubin once tweeted about United healthcare not approving a medicine for his ptn and after the bad rep they ended up approvin)