Re: Remicade and Medicare Question

[Guest guest]

Pretty much it does. I use 5 vials every 8 weeks and the nurse there said that each vial cost the docs office $500. In return for my infusion and medicine my insurance is charged $5000 for every infusion. Luckily my co-pay is on $20 for a specialist.

But after a year of seeing the RA doc and having the infusions our insurance upped our rates by 28% instead of the normal 10% every year. And they said it was due to one person on the plan having high medical bills.

Good Luck

[Guest guest]

The nurse that administers the remicade and I discussed this. She said that each vial is $500. I use 5 vials on every visit which equals up to $2500 for my medicine. For those 3 hours that I sit there hooked up to the iv my insurance is charged $5000. Blue Cross of Georgia sends out a statement after every appointment that you go to. When I started with remicade I was using 3 vials every appointment and it was costing the insurance $3500 then.

[Guest guest]

I started out on 3 vials and then was upped to 5 after 4 treatments because I wasn't getting the results he wanted to see. They explained to me that when you start out they use so many mg per kg ratio to see how much you start off with.

As for the doctor. Luckily I pay a $20 co-pay every 8 weeks for this. There are only 2 RA docs in the city where I live. I don't care what it cost and neither do my parents who have the insurance policy under their business for me. I'm 30 years old and always led an active lifestyle showing reining horses and running barrel horses for the past 20 years. I haven't been able to set foot on a horse to just ride for fun in a year. This devastated my life, not to mention the amount of money we put into the horses that now sit in a pasture useless. So if this doctor can get me back to a normal life with minimal pain, that's all I ask. I believe my doctor truly wants me to get better and is trying to help me accomplish that. That is one reason I have never questioned the cost of any medication he has put me on.

[Guest guest]

I was just looking at my statement for 7 vials and the doctor's bill was $8,820. Medicare allowed only $3,976 as a covered expense and they paid $3,181 (80% of the allowed amount). My doctor reduced his bill to the amount allowed by Medicare so that leaves $795 for my secondary insurance or me. Since most of the cost is for Remicade I think you would pay about 5/7 of the amount I pay, or $568. I hope this helps. God bless.

----- Original Message -----

From: Nina

Rheumatoid Arthritis

Sent: Friday, July 29, 2005 9:31 AM

Subject: Remicade and Medicare Question

I just talked to the doc's office and they contacted the clinic that does their Remicade infusions. They think I would need 5 vials every infusion (every 8 weeks) which would leave my cost (after Medicare) of $600 every 8 weeks. Does that sound about right?

Nina

[Guest guest]

Interesting how your doctor can reduce his bill in half isn't it. But of course the doctors aren't making any money on prescribing medications!

Dorey

----- Original Message -----

From: Harold Van Tuyl

Rheumatoid Arthritis

Sent: Friday, July 29, 2005 9:57 AM

Subject: Re: Remicade and Medicare Question

I was just looking at my statement for 7 vials and the doctor's bill was $8,820. Medicare allowed only $3,976 as a covered expense and they paid $3,181 (80% of the allowed amount). My doctor reduced his bill to the amount allowed by Medicare so that leaves $795 for my secondary insurance or me. Since most of the cost is for Remicade I think you would pay about 5/7 of the amount I pay, or $568. I hope this helps. God bless.

----- Original Message -----

From: Nina

Rheumatoid Arthritis

Sent: Friday, July 29, 2005 9:31 AM

Subject: Remicade and Medicare Question

I just talked to the doc's office and they contacted the clinic that does their Remicade infusions. They think I would need 5 vials every infusion (every 8 weeks) which would leave my cost (after Medicare) of $600 every 8 weeks. Does that sound about right?

Nina

[Guest guest]

Every physician does that. If they charged less, Medicare and Medicaid would pay less. If you've ever been in the position of having no insurance, or having to have something that insurance won't cover, you'll notice that your doctor doesn't charge YOU that exorbitant amount. It's as much a game with the government as everything else is.

----- Original Message -----

From: Dorey

Rheumatoid Arthritis

Sent: Friday, July 29, 2005 2:22 PM

Subject: Re: Remicade and Medicare Question

Interesting how your doctor can reduce his bill in half isn't it. But of course the doctors aren't making any money on prescribing medications!

Dorey

----- Original Message -----

From: Harold Van Tuyl

Rheumatoid Arthritis

Sent: Friday, July 29, 2005 9:57 AM

Subject: Re: Remicade and Medicare Question

I was just looking at my statement for 7 vials and the doctor's bill was $8,820. Medicare allowed only $3,976 as a covered expense and they paid $3,181 (80% of the allowed amount). My doctor reduced his bill to the amount allowed by Medicare so that leaves $795 for my secondary insurance or me. Since most of the cost is for Remicade I think you would pay about 5/7 of the amount I pay, or $568. I hope this helps. God bless.

----- Original Message -----

From: Nina

Rheumatoid Arthritis

Sent: Friday, July 29, 2005 9:31 AM

Subject: Remicade and Medicare Question

I just talked to the doc's office and they contacted the clinic that does their Remicade infusions. They think I would need 5 vials every infusion (every 8 weeks) which would leave my cost (after Medicare) of $600 every 8 weeks. Does that sound about right?

Nina

[Guest guest]

Are you saying your doctor pays $500. for the medication then with one visit and the shot charges out $5,000.

Wholey catfish if this is true these doctors would never want us better.

Dorey

----- Original Message -----

From: slidin2astop@...

Rheumatoid Arthritis

Sent: Friday, July 29, 2005 10:12 AM

Subject: Re: Remicade and Medicare Question

Pretty much it does. I use 5 vials every 8 weeks and the nurse there said that each vial cost the docs office $500. In return for my infusion and medicine my insurance is charged $5000 for every infusion. Luckily my co-pay is on $20 for a specialist.

But after a year of seeing the RA doc and having the infusions our insurance upped our rates by 28% instead of the normal 10% every year. And they said it was due to one person on the plan having high medical bills.

Good Luck

[Guest guest]

I reread this, obviously you have one infusion with 8 vials of medication so your doctors cost is $4,000. and he bills out at $5,000. Still why would he want you better?

----- Original Message -----

From: slidin2astop@...

Rheumatoid Arthritis

Sent: Friday, July 29, 2005 10:12 AM

Subject: Re: Remicade and Medicare Question

Pretty much it does. I use 5 vials every 8 weeks and the nurse there said that each vial cost the docs office $500. In return for my infusion and medicine my insurance is charged $5000 for every infusion. Luckily my co-pay is on $20 for a specialist.

But after a year of seeing the RA doc and having the infusions our insurance upped our rates by 28% instead of the normal 10% every year. And they said it was due to one person on the plan having high medical bills.

Good Luck

[Guest guest]

I worked for insurance and that is correct. The docs will always bill high - the insurance will pay contracted price and the patient pays their copayment. Drug manuf, doctors, pharmacies, all get a cut of the pie. You can try to negotiate a better rate with your doc as I have been told they make a lot on the higher end meds for R.A. - but I can say when I asked my doc - she was not pleased! And did not reduce it. Since she was the only one who diagnosed me correctly - I think she deserves whatever she gets.

The cost for Remicade everyone is talking about appears to be for a very high dosage - I started on it and I think I was on one vial to begin with - which my doc billed out 1800 - insurance covered around 1400 and my percent was 20% - about $260 every 8 weeks - but that was at that dose - you'd have to times it by 6 or whatever on dosage increase - I thought they only increased the dosage if you were having problems on a lesser dose. So you may want to ask about that or call the drug mfg and ask then what the typical dosage is for a first time user. I had success with my dosage and only switched to a self-injectable because it was more convenient for me - I didn't want to have to go the doc every 8 weeks for the rest of my life if I didn't have to - or take the time off work.

These meds are all too expensive - but it is the drug manuf that are making the big bucks on these self-injectables - it is absurd how much they cost - most folks don't realize how much their therapy costs - as they just pay their "copay." And most people could never afford these drugs on their own. And as someone said, yes, they up your insurance rates, when someone is costing them money! It's a no win situation it seems.

Dorey <ddorey@...> wrote:

Interesting how your doctor can reduce his bill in half isn't it. But of course the doctors aren't making any money on prescribing medications!

Dorey

----- Original Message -----

From: Harold Van Tuyl

Rheumatoid Arthritis

Sent: Friday, July 29, 2005 9:57 AM

Subject: Re: Remicade and Medicare Question

I was just looking at my statement for 7 vials and the doctor's bill was $8,820. Medicare allowed only $3,976 as a covered expense and they paid $3,181 (80% of the allowed amount). My doctor reduced his bill to the amount allowed by Medicare so that leaves $795 for my secondary insurance or me. Since most of the cost is for Remicade I think you would pay about 5/7 of the amount I pay, or $568. I hope this helps. God bless.

----- Original Message -----

From: Nina

Rheumatoid Arthritis

Sent: Friday, July 29, 2005 9:31 AM

Subject: Remicade and Medicare Question

I just talked to the doc's office and they contacted the clinic that does their Remicade infusions. They think I would need 5 vials every infusion (every 8 weeks) which would leave my cost (after Medicare) of $600 every 8 weeks. Does that sound about right?

Nina

__________________________________________________

[Guest guest]

?? I don't know what you're saying. What I'm telling you is that if your doctor submitted a bill to medicare, medicaid, or your insurance company, and he submitted less than what they normally do(a really high amount) he would get a lower reimbursement. That's how it works -- he doesn't expect to get reimbursed for the amount he submits, but in order to get reimbursed for what he actually would charge, he has to submit a bill that high.

Just from my teaching experience, I can tell you that people in professions where they work with other people(medical, education, social work) do NOT do it for the money, overall. No one in his/her right mind would put up with the nastiness, sarcasm, and constant harassment that these professionals do, solely for money. You have to love what you do, and sincerely like people in order to be effective and maintain your sanity. There are exceptions in every field, of course, but generally, doctors like what they do, like people, and went into that profession for the healing aspect of it. The longer you work against your physician, and maintain that paranoia, the harder it will be to be healthy. Emotional health is a large part of this disease also.

----- Original Message -----

From: Dorey

Rheumatoid Arthritis

Sent: Friday, July 29, 2005 2:26 PM

Subject: Re: Remicade and Medicare Question

Are you saying your doctor pays $500. for the medication then with one visit and the shot charges out $5,000.

Wholey catfish if this is true these doctors would never want us better.

Dorey

----- Original Message -----

From: slidin2astop@...

Rheumatoid Arthritis

Sent: Friday, July 29, 2005 10:12 AM

Subject: Re: Remicade and Medicare Question

Pretty much it does. I use 5 vials every 8 weeks and the nurse there said that each vial cost the docs office $500. In return for my infusion and medicine my insurance is charged $5000 for every infusion. Luckily my co-pay is on $20 for a specialist.

But after a year of seeing the RA doc and having the infusions our insurance upped our rates by 28% instead of the normal 10% every year. And they said it was due to one person on the plan having high medical bills.

Good Luck

[Guest guest]

Duh. Because he isn't a doctor ONLY for the money. If you honestly believe that, then RA is only a secondary problem.

----- Original Message -----

From: Dorey

Rheumatoid Arthritis

Sent: Friday, July 29, 2005 2:28 PM

Subject: Re: Remicade and Medicare Question

I reread this, obviously you have one infusion with 8 vials of medication so your doctors cost is $4,000. and he bills out at $5,000. Still why would he want you better?

----- Original Message -----

From: slidin2astop@...

Rheumatoid Arthritis

Sent: Friday, July 29, 2005 10:12 AM

Subject: Re: Remicade and Medicare Question

Pretty much it does. I use 5 vials every 8 weeks and the nurse there said that each vial cost the docs office $500. In return for my infusion and medicine my insurance is charged $5000 for every infusion. Luckily my co-pay is on $20 for a specialist.

But after a year of seeing the RA doc and having the infusions our insurance upped our rates by 28% instead of the normal 10% every year. And they said it was due to one person on the plan having high medical bills.

Good Luck

[Guest guest]

8 vials seems awful high for a first time patient! I started one vial I believe - Il'l check and see what my initial dosage was but know it wasn't that much! But I'm not a doctor! And I was a chronic case. It may have to do with weight, I just thought about that as well, as I'm pretty thin, weigh 130.

I can also bet you the doctor makes more than a grand on the one below! Just imagine what the drug mfg. makes!

Dorey <ddorey@...> wrote:

I reread this, obviously you have one infusion with 8 vials of medication so your doctors cost is $4,000. and he bills out at $5,000. Still why would he want you better?

----- Original Message -----

From: slidin2astop@...

Rheumatoid Arthritis

Sent: Friday, July 29, 2005 10:12 AM

Subject: Re: Remicade and Medicare Question

Pretty much it does. I use 5 vials every 8 weeks and the nurse there said that each vial cost the docs office $500. In return for my infusion and medicine my insurance is charged $5000 for every infusion. Luckily my co-pay is on $20 for a specialist.

But after a year of seeing the RA doc and having the infusions our insurance upped our rates by 28% instead of the normal 10% every year. And they said it was due to one person on the plan having high medical bills.

Good Luck__________________________________________________

[Guest guest]

I totally agree with 's emails! I love my rheumy and even though like other specialists, they make the big bucks, they deserve it, after all, they didn't just go to school for all those years for nothing!

As my doctor said, they have to pay their nurses to administer the infusions, overhead, to make ends meet too. They aren't giving these meds just to make money - I don't believe that at all! And I know they are getting cuts thru insurance and Medicare etc. as well - that is pinching their revenue as well.

Hasenstab <saludo@...> wrote:

Duh. Because he isn't a doctor ONLY for the money. If you honestly believe that, then RA is only a secondary problem.

----- Original Message -----

From: Dorey

Rheumatoid Arthritis

Sent: Friday, July 29, 2005 2:28 PM

Subject: Re: Remicade and Medicare Question

I reread this, obviously you have one infusion with 8 vials of medication so your doctors cost is $4,000. and he bills out at $5,000. Still why would he want you better?

----- Original Message -----

From: slidin2astop@...

Rheumatoid Arthritis

Sent: Friday, July 29, 2005 10:12 AM

Subject: Re: Remicade and Medicare Question

Pretty much it does. I use 5 vials every 8 weeks and the nurse there said that each vial cost the docs office $500. In return for my infusion and medicine my insurance is charged $5000 for every infusion. Luckily my co-pay is on $20 for a specialist.

But after a year of seeing the RA doc and having the infusions our insurance upped our rates by 28% instead of the normal 10% every year. And they said it was due to one person on the plan having high medical bills.

Good Luck__________________________________________________

[Guest guest]

Additionally, they pay big bucks for insurance policies to protect themselves from malpractice suits. Whether you are guilty or not, it is very expensive to be sued. Anyone can sue; not everyone can win.

----- Original Message -----

From: sunshine

Rheumatoid Arthritis

Sent: Friday, July 29, 2005 2:54 PM

Subject: Re: Remicade and Medicare Question

I totally agree with 's emails! I love my rheumy and even though like other specialists, they make the big bucks, they deserve it, after all, they didn't just go to school for all those years for nothing!

As my doctor said, they have to pay their nurses to administer the infusions, overhead, to make ends meet too. They aren't giving these meds just to make money - I don't believe that at all! And I know they are getting cuts thru insurance and Medicare etc. as well - that is pinching their revenue as well.

Hasenstab <saludo@...> wrote:

Duh. Because he isn't a doctor ONLY for the money. If you honestly believe that, then RA is only a secondary problem.

----- Original Message -----

From: Dorey

Rheumatoid Arthritis

Sent: Friday, July 29, 2005 2:28 PM

Subject: Re: Remicade and Medicare Question

I reread this, obviously you have one infusion with 8 vials of medication so your doctors cost is $4,000. and he bills out at $5,000. Still why would he want you better?

----- Original Message -----

From: slidin2astop@...

Rheumatoid Arthritis

Sent: Friday, July 29, 2005 10:12 AM

Subject: Re: Remicade and Medicare Question

Pretty much it does. I use 5 vials every 8 weeks and the nurse there said that each vial cost the docs office $500. In return for my infusion and medicine my insurance is charged $5000 for every infusion. Luckily my co-pay is on $20 for a specialist.

But after a year of seeing the RA doc and having the infusions our insurance upped our rates by 28% instead of the normal 10% every year. And they said it was due to one person on the plan having high medical bills.

Good Luck

__________________________________________________

[Guest guest]

When my husband went with me for the first

time my RA doctor, his first comment was "he has a big head "

(size)...I said yea, that's cuz he's very smart!

I also feel that they are deserved to make what they do....they fix us

(most of the time) and every appt ask the same questions, it must get

boring sometimes for them. The nurses in my doc's office seem to know

a lot about the disease and are very caring and helpful.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Maggie

http://www.4HockeyFans.com

http://www.4FloridaHockey.com

MSN: Maggies1429

AOL: Maggies85

sunshine wrote:

I totally agree with 's emails! I love my rheumy and even

though like other specialists, they make the big bucks, they deserve

it, after all, they didn't just go to school for all those years for

nothing!

[Guest guest]

, you misunderstood me, I live in Canada, my doctor doesn't sell me medications, if I want him to give me a shot, like when I had the gold injections, I buy the medication, take it to him and he injects it, his bill is then under $40. to Medical Services.

In Canada things are much different than in the US so I was just in shock, that was all.............and yes, this explains to me why doctors don't review diets or other holistic methods of treatments for patients.

Personally I am well again, through holistic methods and I work very closely with my doctor, having a great relationship.

Dorey

www.LivingWithRheumatoidArthritis.com

----- Original Message -----

From: Hasenstab

Rheumatoid Arthritis

Sent: Friday, July 29, 2005 11:43 AM

Subject: Re: Remicade and Medicare Question

?? I don't know what you're saying. What I'm telling you is that if your doctor submitted a bill to medicare, medicaid, or your insurance company, and he submitted less than what they normally do(a really high amount) he would get a lower reimbursement. That's how it works -- he doesn't expect to get reimbursed for the amount he submits, but in order to get reimbursed for what he actually would charge, he has to submit a bill that high.

Just from my teaching experience, I can tell you that people in professions where they work with other people(medical, education, social work) do NOT do it for the money, overall. No one in his/her right mind would put up with the nastiness, sarcasm, and constant harassment that these professionals do, solely for money. You have to love what you do, and sincerely like people in order to be effective and maintain your sanity. There are exceptions in every field, of course, but generally, doctors like what they do, like people, and went into that profession for the healing aspect of it. The longer you work against your physician, and maintain that paranoia, the harder it will be to be healthy. Emotional health is a large part of this disease also.

----- Original Message -----

From: Dorey

Rheumatoid Arthritis

Sent: Friday, July 29, 2005 2:26 PM

Subject: Re: Remicade and Medicare Question

Are you saying your doctor pays $500. for the medication then with one visit and the shot charges out $5,000.

Wholey catfish if this is true these doctors would never want us better.

Dorey

----- Original Message -----

From: slidin2astop@...

Rheumatoid Arthritis

Sent: Friday, July 29, 2005 10:12 AM

Subject: Re: Remicade and Medicare Question

Pretty much it does. I use 5 vials every 8 weeks and the nurse there said that each vial cost the docs office $500. In return for my infusion and medicine my insurance is charged $5000 for every infusion. Luckily my co-pay is on $20 for a specialist.

But after a year of seeing the RA doc and having the infusions our insurance upped our rates by 28% instead of the normal 10% every year. And they said it was due to one person on the plan having high medical bills.

Good Luck

[Guest guest]

You are a very insulting person, please direct your messages elsewhere!

Dorey

----- Original Message -----

From: Hasenstab

Rheumatoid Arthritis

Sent: Friday, July 29, 2005 11:45 AM

Subject: Re: Remicade and Medicare Question

Duh. Because he isn't a doctor ONLY for the money. If you honestly believe that, then RA is only a secondary problem.

----- Original Message -----

From: Dorey

Rheumatoid Arthritis

Sent: Friday, July 29, 2005 2:28 PM

Subject: Re: Remicade and Medicare Question

I reread this, obviously you have one infusion with 8 vials of medication so your doctors cost is $4,000. and he bills out at $5,000. Still why would he want you better?

----- Original Message -----

From: slidin2astop@...

Rheumatoid Arthritis

Sent: Friday, July 29, 2005 10:12 AM

Subject: Re: Remicade and Medicare Question

Pretty much it does. I use 5 vials every 8 weeks and the nurse there said that each vial cost the docs office $500. In return for my infusion and medicine my insurance is charged $5000 for every infusion. Luckily my co-pay is on $20 for a specialist.

But after a year of seeing the RA doc and having the infusions our insurance upped our rates by 28% instead of the normal 10% every year. And they said it was due to one person on the plan having high medical bills.

Good Luck

[Guest guest]

I will drop this, you aren't seeing the point. It's criminal doctors being paid to give prescriptions, in my opinion. Look how our society is so over medicated.

Dorey

Dorey

----- Original Message -----

From: sunshine

Rheumatoid Arthritis

Sent: Friday, July 29, 2005 11:54 AM

Subject: Re: Remicade and Medicare Question

I totally agree with 's emails! I love my rheumy and even though like other specialists, they make the big bucks, they deserve it, after all, they didn't just go to school for all those years for nothing!

As my doctor said, they have to pay their nurses to administer the infusions, overhead, to make ends meet too. They aren't giving these meds just to make money - I don't believe that at all! And I know they are getting cuts thru insurance and Medicare etc. as well - that is pinching their revenue as well.

Hasenstab <saludo@...> wrote:

Duh. Because he isn't a doctor ONLY for the money. If you honestly believe that, then RA is only a secondary problem.

----- Original Message -----

From: Dorey

Rheumatoid Arthritis

Sent: Friday, July 29, 2005 2:28 PM

Subject: Re: Remicade and Medicare Question

I reread this, obviously you have one infusion with 8 vials of medication so your doctors cost is $4,000. and he bills out at $5,000. Still why would he want you better?

----- Original Message -----

From: slidin2astop@...

Rheumatoid Arthritis

Sent: Friday, July 29, 2005 10:12 AM

Subject: Re: Remicade and Medicare Question

Pretty much it does. I use 5 vials every 8 weeks and the nurse there said that each vial cost the docs office $500. In return for my infusion and medicine my insurance is charged $5000 for every infusion. Luckily my co-pay is on $20 for a specialist.

But after a year of seeing the RA doc and having the infusions our insurance upped our rates by 28% instead of the normal 10% every year. And they said it was due to one person on the plan having high medical bills.

Good Luck

__________________________________________________

[Guest guest]

Medicare reimbursements are based on a fraction of what they call "normal" costs for the service. If all doctors only billed what Medicare allows that would then become the basis for "normal" costs and Medicare would allow about 80% of these costs. That way the Medicare allowance and reimbursement would go down each year. If all doctors billed twice what Medicare now allows the Medicare allowance would eventually reach perhaps 80% of the new amount billed by the doctors. That's why many doctors either refuse to take Medicare patients or insist on payment for their full fee instead of accepting only what Medicare allows. At least that's how I see it.

----- Original Message -----

From: sunshine

Rheumatoid Arthritis

Sent: Friday, July 29, 2005 11:43 AM

Subject: Re: Remicade and Medicare Question

I worked for insurance and that is correct. The docs will always bill high - the insurance will pay contracted price and the patient pays their copayment. Drug manuf, doctors, pharmacies, all get a cut of the pie. You can try to negotiate a better rate with your doc as I have been told they make a lot on the higher end meds for R.A. - but I can say when I asked my doc - she was not pleased! And did not reduce it. Since she was the only one who diagnosed me correctly - I think she deserves whatever she gets.

The cost for Remicade everyone is talking about appears to be for a very high dosage - I started on it and I think I was on one vial to begin with - which my doc billed out 1800 - insurance covered around 1400 and my percent was 20% - about $260 every 8 weeks - but that was at that dose - you'd have to times it by 6 or whatever on dosage increase - I thought they only increased the dosage if you were having problems on a lesser dose. So you may want to ask about that or call the drug mfg and ask then what the typical dosage is for a first time user. I had success with my dosage and only switched to a self-injectable because it was more convenient for me - I didn't want to have to go the doc every 8 weeks for the rest of my life if I didn't have to - or take the time off work.

These meds are all too expensive - but it is the drug manuf that are making the big bucks on these self-injectables - it is absurd how much they cost - most folks don't realize how much their therapy costs - as they just pay their "copay." And most people could never afford these drugs on their own. And as someone said, yes, they up your insurance rates, when someone is costing them money! It's a no win situation it seems.

Dorey <ddorey@...> wrote:

Interesting how your doctor can reduce his bill in half isn't it. But of course the doctors aren't making any money on prescribing medications!

Dorey

----- Original Message -----

From: Harold Van Tuyl

Rheumatoid Arthritis

Sent: Friday, July 29, 2005 9:57 AM

Subject: Re: Remicade and Medicare Question

I was just looking at my statement for 7 vials and the doctor's bill was $8,820. Medicare allowed only $3,976 as a covered expense and they paid $3,181 (80% of the allowed amount). My doctor reduced his bill to the amount allowed by Medicare so that leaves $795 for my secondary insurance or me. Since most of the cost is for Remicade I think you would pay about 5/7 of the amount I pay, or $568. I hope this helps. God bless.

----- Original Message -----

From: Nina

Rheumatoid Arthritis

Sent: Friday, July 29, 2005 9:31 AM

Subject: Remicade and Medicare Question

I just talked to the doc's office and they contacted the clinic that does their Remicade infusions. They think I would need 5 vials every infusion (every 8 weeks) which would leave my cost (after Medicare) of $600 every 8 weeks. Does that sound about right?

Nina

__________________________________________________

[Guest guest]

I'm just thankful that I live in Canada where all my doctor visits were 100% covered by medical and my extended medical was no limit for prescription medications............even with that, I found a healthier way that I paid for because the side effects of the meds were almost as bad as the disease itself. I thought, what good having my joints not hurt if I still can't do anything because I'm sick and have heart burn so bad I can't bend over for fear of throwing up. Yuck, didn't suit me.

And it's not always easy going the holistic route either.......sometimes I so crave not having to watch what I eat but I put myself in this position through my lack of understanding how to maintain a healthy body, so now I'll live with to few changes I need to maintain my health.

Why I don't like doctors getting paid for prescribing meds is it seems this stops them from investigating holistic methods that might very well work better than the meds. I ask you, how many of your Rheumatologists bothered reviewing your diets, ensuring your gut isn't filled with parasites?

And teachers getting renumerated for getting kids on ridalin...............I won't go there.

Dorey

www.LivingWithRheumatoidArthritis.com

----- Original Message -----

From: Maggie

Rheumatoid Arthritis

Sent: Friday, July 29, 2005 12:01 PM

Subject: Re: Remicade and Medicare Question

When my husband went with me for the first time my RA doctor, his first comment was "he has a big head " (size)...I said yea, that's cuz he's very smart! I also feel that they are deserved to make what they do....they fix us (most of the time) and every appt ask the same questions, it must get boring sometimes for them. The nurses in my doc's office seem to know a lot about the disease and are very caring and helpful.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Maggie

http://www.4HockeyFans.com

http://www.4FloridaHockey.com

MSN: Maggies1429

AOL: Maggies85sunshine wrote:

I totally agree with 's emails! I love my rheumy and even though like other specialists, they make the big bucks, they deserve it, after all, they didn't just go to school for all those years for nothing!

[Guest guest]

If you're talking about Canada, I can't address that because I don't know anything about the Canadian educational system, but I can tell you that NO ONE is getting "renumerated" (sic) for "getting" kids on ritalin here. I only wish you had to deal with a child in hysterics because he can't read and can't pay attention one-on-one long enough to learn the alphabet. I've spent my entire life in special ed and unless you have too, you have no business blasting teachers.

And teachers getting renumerated for getting kids on ridalin...............I won't go there.

Dorey

www.LivingWithRheumatoidArthritis.com

----- Original Message -----

From: Maggie

Rheumatoid Arthritis

Sent: Friday, July 29, 2005 12:01 PM

Subject: Re: Remicade and Medicare Question

When my husband went with me for the first time my RA doctor, his first comment was "he has a big head " (size)...I said yea, that's cuz he's very smart! I also feel that they are deserved to make what they do....they fix us (most of the time) and every appt ask the same questions, it must get boring sometimes for them. The nurses in my doc's office seem to know a lot about the disease and are very caring and helpful. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Maggie

http://www.4HockeyFans.com

http://www.4FloridaHockey.com

MSN: Maggies1429

AOL: Maggies85sunshine wrote:

I totally agree with 's emails! I love my rheumy and even though like other specialists, they make the big bucks, they deserve it, after all, they didn't just go to school for all those years for nothing!

[Guest guest]

Understandly - you are not concerned with cost - as you have an excellent co-pay - most of us don't have - I think if you were told your medicine would cost you 500-1000/month - then you might be concerned? That's what some of us have been told at one point or the other with insurance and who we work for - I had to change jobs because I couldn't afford my copayment of 400-600 a month, now it would have been twice that, with my dosage increase, if I hadn't got a new job with better benefits.

Not sure how anyone can afford that kind of expense for the rest of their life! slidin2astop@... wrote:

I started out on 3 vials and then was upped to 5 after 4 treatments because I wasn't getting the results he wanted to see. They explained to me that when you start out they use so many mg per kg ratio to see how much you start off with.

As for the doctor. Luckily I pay a $20 co-pay every 8 weeks for this. There are only 2 RA docs in the city where I live. I don't care what it cost and neither do my parents who have the insurance policy under their business for me. I'm 30 years old and always led an active lifestyle showing reining horses and running barrel horses for the past 20 years. I haven't been able to set foot on a horse to just ride for fun in a year. This devastated my life, not to mention the amount of money we put into the horses that now sit in a pasture useless. So if this doctor can get me back to a normal life with minimal pain, that's all I ask. I believe my doctor truly wants me to get better and is trying to help me accomplish that. That is one reason I have never questioned the cost of any medication he has put me on.

Start your day with - make it your home page

[Guest guest]

It is being judgmental to insist people don't need meds and can heal by holistic medicine. I have friends who insist I don't need my meds either - I beg to differ though and live in my body for the past 2 years -

I do agree with that there are too many people are medication that probably don't or wouldn't need it if they just exercised, such as anti-depressants, anxiety and sleep aids - but there are people who do need it because they are clinically depressed and for various other reasons.

While I understand that some people believe in it, and I have looked into it, it is not for everyone and like admitted, docs don't try it, why, because they don't have the clinical trials and success outcomes like these other meds that have gone thru all the research and clinical trials. In my opinion, they treat us with what they have seen "works" and prevents future joint damage, not just hides the pain. Not something that "might" work.

It is a personal "choice" of what they want to take - that is the hardest thing I find with discussing this disease with people. Everyone acts like they are experts on the matter - but only you know what works for you and what you feel comfortable with.

We all need to realize we are just giving "our opinions" - and hope to help others on here - not make everyone mad. Let's move on before we all have flare-ups!

P.S. - - I understand the below - I have a brother who is mentally retarded/non-verbal and a former step-daugther who I still love who is autistic and now has anxiety anorexia - a very serious disease - I know too well - how it is to have a child let alone a sibling with a mental disease - until you do - I think it hard for others to understand the complexity of such.

Hasenstab <saludo@...> wrote:

If you're talking about Canada, I can't address that because I don't know anything about the Canadian educational system, but I can tell you that NO ONE is getting "renumerated" (sic) for "getting" kids on ritalin here. I only wish you had to deal with a child in hysterics because he can't read and can't pay attention one-on-one long enough to learn the alphabet. I've spent my entire life in special ed and unless you have too, you have no business blasting teachers.

And teachers getting renumerated for getting kids on ridalin...............I won't go there.

Dorey

www.LivingWithRheumatoidArthritis.com

----- Original Message -----

From: Maggie

Rheumatoid Arthritis

Sent: Friday, July 29, 2005 12:01 PM

Subject: Re: Remicade and Medicare Question

When my husband went with me for the first time my RA doctor, his first comment was "he has a big head " (size)...I said yea, that's cuz he's very smart! I also feel that they are deserved to make what they do....they fix us (most of the time) and every appt ask the same questions, it must get boring sometimes for them. The nurses in my doc's office seem to know a lot about the disease and are very caring and helpful. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Maggie

http://www.4HockeyFans.com

http://www.4FloridaHockey.com

MSN: Maggies1429

AOL: Maggies85sunshine wrote:

I totally agree with 's emails! I love my rheumy and even though like other specialists, they make the big bucks, they deserve it, after all, they didn't just go to school for all those years for nothing!

Start your day with - make it your home page

[Guest guest]

I have a son whose teacher tried to label him ADD........I know my son could be a challenge in class because he enjoyed socializing, but ADD was not the problem, of that I was certain. Certain enough that I spent the money to have my son tested and he tested in the 98th percentile for attention, with the psychologist saying that any teacher who couldn't keep his attention was just not trying things that work for this particular child........So, no I'm not a teacher, just a parent who cares about her child and didn't want him doing the ritalin dance.

Dorey

----- Original Message -----

From: Hasenstab

Rheumatoid Arthritis

Sent: Friday, July 29, 2005 1:47 PM

Subject: Re: Remicade and Medicare Question

If you're talking about Canada, I can't address that because I don't know anything about the Canadian educational system, but I can tell you that NO ONE is getting "renumerated" (sic) for "getting" kids on ritalin here. I only wish you had to deal with a child in hysterics because he can't read and can't pay attention one-on-one long enough to learn the alphabet. I've spent my entire life in special ed and unless you have too, you have no business blasting teachers.

And teachers getting renumerated for getting kids on ridalin...............I won't go there.

Dorey

www.LivingWithRheumatoidArthritis.com

----- Original Message -----

From: Maggie

Rheumatoid Arthritis

Sent: Friday, July 29, 2005 12:01 PM

Subject: Re: Remicade and Medicare Question

When my husband went with me for the first time my RA doctor, his first comment was "he has a big head " (size)...I said yea, that's cuz he's very smart! I also feel that they are deserved to make what they do....they fix us (most of the time) and every appt ask the same questions, it must get boring sometimes for them. The nurses in my doc's office seem to know a lot about the disease and are very caring and helpful. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Maggie

http://www.4HockeyFans.com

http://www.4FloridaHockey.com

MSN: Maggies1429

AOL: Maggies85sunshine wrote:

I totally agree with 's emails! I love my rheumy and even though like other specialists, they make the big bucks, they deserve it, after all, they didn't just go to school for all those years for nothing!

[Guest guest]

I know I was afraid too. When my husband sold his company we had it in the contract that we would always stay with the same extended benefits package as my meds at that time were in excess of $400. per month and climbing.

Dorey

----- Original Message -----

From: sunshine

Rheumatoid Arthritis

Sent: Friday, July 29, 2005 1:55 PM

Subject: Re: Remicade and Medicare Question

Understandly - you are not concerned with cost - as you have an excellent co-pay - most of us don't have - I think if you were told your medicine would cost you 500-1000/month - then you might be concerned? That's what some of us have been told at one point or the other with insurance and who we work for - I had to change jobs because I couldn't afford my copayment of 400-600 a month, now it would have been twice that, with my dosage increase, if I hadn't got a new job with better benefits.

Not sure how anyone can afford that kind of expense for the rest of their life! slidin2astop@... wrote:

I started out on 3 vials and then was upped to 5 after 4 treatments because I wasn't getting the results he wanted to see. They explained to me that when you start out they use so many mg per kg ratio to see how much you start off with.

As for the doctor. Luckily I pay a $20 co-pay every 8 weeks for this. There are only 2 RA docs in the city where I live. I don't care what it cost and neither do my parents who have the insurance policy under their business for me. I'm 30 years old and always led an active lifestyle showing reining horses and running barrel horses for the past 20 years. I haven't been able to set foot on a horse to just ride for fun in a year. This devastated my life, not to mention the amount of money we put into the horses that now sit in a pasture useless. So if this doctor can get me back to a normal life with minimal pain, that's all I ask. I believe my doctor truly wants me to get better and is trying to help me accomplish that. That is one reason I have never questioned the cost of any medication he has put me on.

Start your day with - make it your home page