Infusions and change of insurance
Sun, April 13, 2025 4:22 PM
I've been diagnosed with UC since 2001 and began receiving infliximab infusion treatments in 2023, which have proven to be very effective at preventing any new flare-ups. I had been on Medicaid which covered these treatments, but then I started a new job and was earning a bit above the income limit and was required to apply for different insurance. As had been my concern, I was told that the facilities and doctors I'd been seeing for over a decade didn't accept private insurance, so I would need to find all new ones. Although that's an inconvenience in itself, my main issue was that it would inevitably take a good deal of time to get set up with new specialists and then have them refer me to a new infusion center to hopefully continue these lifechanging treatments. Although it would only be a temporary solution, I did apply for Continuity of Care to attempt to continue with infusions at least for the short term, but had trouble just getting in touch with someone, and then never heard back about my request. Shortly after all this, I was laid off from my job and was eventually able to revert back to my Medicaid coverage due to the drop in income. However, as with everything else, this was an unexpectedly difficult and lengthy process which caused me to miss several months of infusions (which I'd been told can potentially render them useless in the long term if you go too long without). So, my question is: since I certainly don't intend to (and can't afford to) remain just below the Medicaid cutoff; when I do have another increase in income and am forced to change my insurance again, does anyone have any suggestions I may not have thought of in order to, at the very least, continue my infusion treatments without an extended interruption? I understand that my doctors just may not accept this current insurance, but it seems like there should be some kind of protection in place to prevent patients from having to suddenly stop crucial long-term treatments for chronic conditions. Applying for Continuity of Care seemed like the best option I had, but even that was going to take an unknown amount of time for approval (if they had actually provided me assistance). It seems a bit crazy that I basically need to choose between living below the poverty line and receiving treatment or increasing my income at the risk of compromising these treatments and my health. Apologies for the length of this post, but wanted to thoroughly describe my situation in case anyone has experienced anything similar. Any thoughts or input would be greatly appreciated!
marschall44Joined Apr 7, 2025
Mon, April 21, 2025 3:15 PM
Reply posted for marschall44.
Thank you for sharing your experience. Managing the costs of Crohn’s disease or ulcerative colitis can feel overwhelming, and you are certainly not alone in facing these challenges. Many in the IBD community share your concerns about health insurance, medication expenses, and out-of-pocket costs. The Crohn’s & Colitis Foundation offers a range of resources to help you navigate these issues and find the support you need, but there are also other resources out there that may help:
Managing the Cost of IBD | Crohn's & Colitis Foundation
Provides information about managing costs of care
Patient financial assistance programs | Crohn's & Colitis Foundation
This resource provides a list of variious patient assistance programs offered by manufacturers of drugs. People who are insured may qualify for these programs to obtain treatment coverage.
External resources:
Webinars - Triage Health Provides various webinars and other tools to better understand aspects of care and cost.
For further questions about Managing the Costs of care, you may also contact our IBD Help Center for additional resources and tips: info@crohnscolitisfoundation.org or contact 888 694 8872 extension 8.
Joined Oct 12, 2017
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