what would you do?

luvboston

The repro immunologist suggested that I take Humira for my high TNF I agreed but said that we were going to need assistance paying for it as at the same time we have to have LIT (2x) which is $600 a pop plus all the travel expenses. So they suggested Abbott Patient Assistance and said it would take 3days to get an answer well I am 1 month in and still they are screwing around and keep asking for my insurance to file an appeal, my insurance does not cover Humira except for RA, they hardly cover my PIO when I am pg. I have tried to tell the case manager that they will not file an appeal and my doc has also spoken to them and is now trying to force the insurance company to send Abbott a letter. Tuesday is the deadline for me to take the first Humira shot in order to cycle at the beg of Feb we were supposed to do an IUI 3 weeks after the last shot and 5 weeks after the LIT. Do you think I should just break down and pay the 2k for Humira or do you think I should give up hope on this cycle and fight it out with Abbott risking my immune system possibly misbehaving while we wait the extra month? 

Mrs.McIrish

I just googled the application and it says you have to submit proof of income. Not sure what level they cut off at but they also want the doctor to fill out the diagnosis code. IF is not listed obviously. It is RA and Crohn's disease. There is an"other" box but i wonder if the manufacturer would give away the drug for IF treatment if it really wasn't created to treat IF issues initially.  I'd hate you to wait and still have them deny you due to eligibility requirements.. 

kmc84

ticker warning........

 

Has your doc considered other TNF inhibitors, like Enbrel or Remicade, or does he want you to stick with Humira?  Maybe you would have better luck with another company for assistance. The costs of those drugs are unreal. Does your doc have any drug samples to get you started?

PrettyAccountant

Mrs.McIrish:

I just googled the application and it says you have to submit proof of income. Not sure what level they cut off at but they also want the doctor to fill out the diagnosis code. IF is not listed obviously. It is RA and Crohn's disease. There is an"other" box but i wonder if the manufacturer would give away the drug for IF treatment if it really wasn't created to treat IF issues initially.  I'd hate you to wait and still have them deny you due to eligibility requirements.. 

This exactly - I doubt the manufacturer would get in to a situation where they give away the drugs when it may not be FDA approved for that reason. I hope your situation resolves (in your favor) very soon.