Crohn's Disease Forum » General IBD Discussion » Insurance and prescriptions


02-09-2015, 01:06 PM   #1
scootter
 
Join Date: Jan 2015
Location: Brainerd, Minnesota

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Insurance and prescriptions

Hello!

I cannot believe it took me this long to find this forum but I am so happy I did. I have been dealing with Crohn's longer than I can remember and have tried almost all of the treatments available. I have no large intestine and have an ileostomy. That is the short version of my Crohn's.

My doctors at Mayo Clinic give me 3 options for my current bout with Crohn's. Tacrolimus, Stelara or surgery. My current issue is a fairly large Crohn's infected ulcer in my intestine.

My issue is my health insurance is being crazy and will not cover either of those drugs 100% so it would cost me $600 a month. Even crazier is they will cover a hospital stay and surgery but not a preventive medicine!

I guess my question, is this typical of insurance? Anyone deal with something like this?

I prefer not to just jump into surgery but I also cannot continue to suffer.

-Scott
02-09-2015, 01:43 PM   #2
araceli
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Location: El paso, Texas

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Insurance will cover medicines that are approved for the disease they treat. In some cases some medicines are known to work for crohn's but they were approved for other disease so they will consider that to be experimental. Crazy, I know.
__________________
Mom/ Girl 19
dx 2011 crohn's in terminal ileum, peri-anal
Prior Meds Asacol, Prednisone, nexium
Current meds.
Remicade since Nov. 2012
Supplements
5000 Vit. D, Multi-Vitamins with Iron
Currently in REMISSION :dance

Mom/ 16 boy
Amplified musculoskeletal pain
Prior. Prednisone, sulfasadine,
Currently. Celebrex, gabapentin, amitriptyline.
02-09-2015, 10:14 PM   #3
2thFairy
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Hey scootter! Welcome to the forum! There is also a stoma subforum that you can check out if you have stoma questions: http://www.crohnsforum.com/forumdisplay.php?f=46

Many insurance companies these days will gladly cover a perceived one-time surgery rather than a long-term expensive drug maintenance. It works out much cheaper for them.
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Ulcerative colitis

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"The colon seems an unlikely candidate for dramatic effect, but now and then it serves that purpose well." The Associated Press Guide to Punctuation
02-09-2015, 10:48 PM   #4
scootter
 
Join Date: Jan 2015
Location: Brainerd, Minnesota

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Thanks guys! I suppose that makes sense on the insurances end.

I actually heard from my Dr. today and it looks like I am going under the knife again. Headed back to Mayo to talk to the surgeon soon.
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