Remicade, Insurance

kjohns

New Member

Joined : Jul 2015

Posts : 3

Posted 4/6/2016 6:04 AM (GMT 0)

I am trying to get Remicade approved. I have Anthem for my medical coverage and Catamaran Optum for my perscription drug coverage. Anthem denied the infusions, saying they only cover specialty drugs in the er or for inpatients. We are now working on a prior auth through my prescription drug company, Catamaran.

Do the prescription drug companies cover the the infusion center's bill too? Or just the actual drug?

Dikid

Veteran Member

Joined : May 2015

Posts : 2236

Posted 4/6/2016 6:11 AM (GMT 0)

If it's covered insurance will cover the infusion center.
Look into remistart.

Also, just today the fda approved inflectra which is a biosimilar to remicade.
It is cheaper but I am not sure if they will have patient assistance like remicade

There is no reason for your insurance to deny either one of them. As there is proven efficacy.

gizmo

Regular Member

Joined : Feb 2016

Posts : 70

Posted 4/6/2016 10:50 AM (GMT 0)

Ask your doctor to try contact your insurance. I too, had trouble getting my insurance approval; but through the persistence of my doctors' business office, they did approve me for another year. Good luck!!

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