Skip to content

Insurance Won’t Approve Remicade Every 6 Weeks

Update – On Remicade for 9 months now. Working great but not lasting full 8 weeks in between infusions. Blue Shield will not allow me to receive infusions any more than every 8 weeks!

My Current Story:

I’ve had UC since 2003….been on Remicade since January 2011. Been going great – pretty much symptom free. My problem is the 8 week infusion cycle is too long for me. My body starts to go back to its old ways around week 5 1/2…..more frequent trips to the bathroom, looser stools, gut pain, nausea, fatigue, etc… My GI said we needed to move it up to every 6 weeks so I can stay on the up side of my disease. I was very excited with that news. Well – that was almost 7 weeks ago! I have since been batting with blue shield to approve it! I have been through one audit process (that yielded a big fat NO) and now am starting a second one!

Is there anyone out there that has had to have their infusion cycle increased? And did you have any trouble with your insurance? Any suggestions or new routes to try?

 My medications:

Remicade 10mg per kg every 8 weeks
Lialda
Methotrexate

Submitted in the Colitis Venting Area by Megan