Kickas.org Forums Ankylosing Spondylitis General Discussion #1 AS Web Support Group Anyone on Remicade with Medicare?

Hi folks..
Just wondering if anyone here is on Remicade and Medicare D? I just signed up with Blue Cross Blue Shield of Tx for my Medicare part D program. The young lady that helped me said my Remicade was covered for 20.00 under rx. But I am confused because Medicare covered it under hospital or doc visits I think at 80 percent coverage. So I am confused because it's an infusion of some sort isnt it?

I looked up Arava which was my Rheumy's other choice about a year ago and its covered at a little lower price than that as well. Either way I am thrilled at having a lower cost on my meds. I'm a bit apprhensive of the the Remicade infusion but at this point I am ready to try that or Arava. The inflammation lately has caused my thoracic to ache so much that my upper back has a not so nice 5-6" speed bump. I'm afraid if I dont do something soon who knows what my back will decide to do next. The damage has already begun to show on my xrays so I know I have to start a plan.

Any feedback on Remicade results would be so greatly appreciated! If I put this on the wrong forum my apologies I just wanted as many Remi users to see if possible!
Hugs from bugs]]]

Hi ladybuggie,

I have traditional BC/BS which covers the actual infusion process at the rheumy office. My prescription plan covers the drug. Some medical policies do cover both.

I get my third infusion this week and am beginning to see some benefit. I hope it will get better and better. For some, the results are immediate. Others, like myself, just take a while.

Your chidren are beautiful and their mother is very courageous. Good luck on the Remicade and please let us know how you respond.

bugs, aloha

in addition to medicare A & B and now D...they offer a medigap policy to cover the twenty percent deductible/copay
for remicade...i've been informed it's about $ 87 a month inconnecticut...or was as of lasst year.

since remicade is an infusion...it's a " proceedure " not a prescription med.

best to you...good luck
aB

Hey Bugster, I can't speak to your coverage question, but you are right, Remicade is an infusion that is usually done in hospital or at a doc's office. It takes about three hours (although I always book four off work, because you never know what's going to slow things down). Remicade only lasts 24 hours after it's been mixed, so I would think that you won't actually pick up your dose until you are at wherever you go for the infusion and they've already checked you out. I go to the rheumatology clinic at Dr. Inman's hospital, they check me out, then I take the prescription to the hospital pharmacy and only then does the pharmacist start mixing it all up. It takes about half an hour to make up, by the way.

Anyway, as far as results are concerned, I've not felt this good in about 20 years. I still have pain - lower back and thoracics - but it's nothing like it was when there was inflammation involved. This is pain due to structural damage that had already occurred.

I am sorry to hear about your thoracic damage, honey. That must be discouraging. I would recommend pilates to help your spine - just a slow absolute beginners class. I wish I had more to help you, Ange. That 'topes' on your spine must be obliterated, darnit!!!

Anyway, if all else fails, we both know that there's nothing chocolate won't cure.

Many warm hugs,

Thank you LB,
I'm glad to hear Remicade is offering you some relief..That is encouraging for this nervous little bug!
I called the Remicade nurse a few days ago and she said my Medicare will cover 80% but the rest is quite a bit so she gave me a number for financial assistance for that gap. I called them up and they said I qualified after a prescreening. I should receive the forms shortly and once I mail it out I'll get a response within 5-7 business days.

I guess I'm just a little nervous after having had so many allergic reactions to meds in my life that the thought of an infusion makes me a bit uneasy.

May the Remicade continue to improve with you as well!!

hi kat...
but of course my dear...chocolate is my cure all when all else fails.
the thoracic pain is the most testy of all my as pain. i am so very happy to hear that remicade has brought you some relief. i have alot of structural damage as well which of course i can do nothing about but if it can stop some of the damage from proceeding then it will be well worth it. i would love to be able to wake up in the mornings without crab walking and hands in little balled up fists. i've got to get myself read for gianna's soccer season! she's doing much better and i cannot wait to get myself down on that field!

hugs]]] from bug\]\\

aloha my friend!
i am not sure about that over here in texas..but i am hopefully going to get assistance for the gap by another financial group. i qualified after the pre screened phone call and should receive the paperwork in a few days. i cant remember their name but they'll cover that gap. i am so excited ben..the thought of some relief...i want to enjoy the soccer season as much as i can !

take care !

And, then, there is the dougnut hole, buggie.

Best regards,

Part D minus

jc...baby, aloha

so nice to your work again....

I WANT TO GO TO THE STARS...but i'll take Mars as a substitute.