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Crohn's Disease Forum » Treatment » Humira/Adalimumab » I Need humira but Medicaid won't approve it


11-17-2014, 12:40 PM   #1
Dogluv
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I Need humira but Medicaid won't approve it

Hi everyone,
It's been forever since I was on here last, I was doing well on LDN for a while, but it eventually became ineffective for my crohns. A few months ago I restarted remicade, I had one infusion, everything seemed to be going well, but exactly I week later I woke up in extreme pain, barley able to move. It turns out I had a delayed hypersensitivity reaction to the remicade, so I had to discontinue treatments. The unfortunate thing is that the remicade really worked for me, I have severe crohns, along with a pretty bad case of perianal disease, and the remicade healed everything up. It's been a couple months since all that happened, and I'm starting to decline, my SED rate is up to 45, and I'm going to the bathroom frequently. My doctor said that my best option at this point is humira, because of its close similarity to remicade, so I agreed to take it. The problem I'm encountering now is that my insurance, Medicaid, refuses to cover humira. My doctor is doing everything to try to get it approved, but isn't having much luck. I checked the humira website but it says that the discount humira program isn't avaliable for someone who's on government insurance. I'm at the point where I really need this medication, as I wait My condition continue to decline. Any suggestions or advice would be greatly appreciated.
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Larissa
Diagnosed with severe crohns disease and perianal disease in April 2011

Been on:
Pentasa
Remicade
Elemental diet
Flagyl
Cipro
Prednisone
Hyperbaric oxygen therapy
Specific carbohydrate diet
Currently on:
LDN (low dose naltrexone)
Trying to get approval for humira
11-17-2014, 12:45 PM   #2
FrozenGirl
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I'm sorry this is happening to you. I am in Canada so no help on the insurance front, hopefully one of our US people have some suggestions. I hope it works out.
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Dx: Ulcerative Colitis, Nov 2013
Currently on:
Mezavant 4.8g
Vitamin D 1000iu
Calcium
Tecta 40mg
Remicade: 600mg, every 4 weeks
Methotrexate: 15 mg (injection)
11-20-2014, 11:44 PM   #3
Miss Underestimated
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Location: Norfolk, Virginia
I'm so sorry you're having such a hard time getting it approved. Hang in there and fight. It's pathetic what they do to people in your situation. Just don't give up. Go back again and again. If they approved Remicade, there's no reason they can't approve Humira.
__________________
*Sick since 1987; managed on my own;
*diagnosed 2008 when I underwent emergency surgery;
*various meds and tests 2008-2012,
*Jan 2012-present, Humira. No symptoms, but scopes indicated disease.
*6MP for all of 2013.
*2014 &2015 complete mucosal healing.

**Staying on Humira for maintenance**

The statistics I see so far for my situation seem pretty good. There ARE long term statistics for the Anti-TNF drug treatments now. I'm here to make them longER.
11-20-2014, 11:47 PM   #4
Miss Underestimated
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Location: Norfolk, Virginia
Medicaid is the US version of government paid health insurance.
11-29-2014, 04:37 PM   #5
Miss Underestimated
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Any news on this front? How about trying one of the fund raising websites, or putting up your own blog or website, make a video of yourself and your story - we can help it go viral. Are you up to any of these kind of efforts? I don't think medicaid deducts charity donations. The monsters that they are. Just wait til something hits one of their famiyl members. Oh, that's right, we tax payers have them covered, and with much better plans than they give you. Forgive my cynicism.
11-29-2014, 04:52 PM   #6
Miss Underestimated
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Location: Norfolk, Virginia
I was looking for some new graphics for my profile here, and came across some interest stuff. 1. you can register and read/whatch at medscape as a consumer. read the terms. then read your hearts out so you are armed with facts and research when you talk to your doctor. 2. a nice little blog, if she's a member here already, my apologies, I didn't know. If not, maybe we should invite her Kellyontherun

so, from Kellyontherun, I swiped something she probably got someplace else. it's where my picture should be, but isn't.

Last edited by Miss Underestimated; 11-29-2014 at 05:18 PM.
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