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insurance coverage


Fri, March 11, 2022 4:17 PM

Reply posted for jan11.

Can anybody comment on how their medigap plan covers their Remicade or other infused biologic? I have been getting Remicade for years but I will soon retire and switch from employee health insurance to Medicare. I'll need to choose a supplement plan soon and any voice of experience would be greatly appreciated. I have called Medicare and many insurance companies in an attempt to get actual numbers or even a percent coverage number. You can imagine how those calls went. I have heard I should steer clear of the so called advantage plans from some of the nurses at my last infusion center, but nothing concrete. Thanks!

FPO Tim57
Joined Mar 11, 2022

Sun, April 23, 2023 2:39 PM

Reply posted for Tim57.

For myself, Medicare and Medigap coverage completely (entirely!) cover INFUSED biologics like Remicade and Entyvio.  They may, however, make you try another self-administered drug (like Humera or Stelara) before they will let you take the infused biologic.  The covered amount on those is pitiful!

Good luck and enjoy your retirement!!!

FPO dami nln
Joined Apr 21, 2023

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