I have been appealing my insurance company for three months to try to get them to cover the cost of Enbrel. Last week (after the 5th appeal) they informed me that they would cover the cost if the injections were done at my derm's office and administered by him. This would mean driving 40 minutes 1 way, twice a week for injections. Every visit would also be an office call charge of $53. My derm has never heard of such a thing and is writing one more appeal letter. I am very concerned that they will turn him down again and that I will not be able to try Enbrel. With winter coming up I am not sure that the drive is the best thing to do. I am currently on MTX and saw great clearing at first but it seems to have stopped (cleared about 60%). Has anyone had a similiar request from their insurance company? Any suggestions??
Thanks

Hi beaser. Sorry your having some trouble with your insurance company, but at least they now have okayed you and they are going to cover the cost of your enbrel! You can get your nurse at the derm's office to inject you, (the derm actually doesn't do it anyway right? Always the nurses every place that I know of) and they shouldn't charge you an office visit charge. That's not fair, but in reality, you can get two shots on one day per week and that will help with the driving and cost, plus it's a heck of alot cheaper than paying close to 2000.00 for your enbrel monthly! I have been on Enrel for 7 and a half months and I will tell you it's been wonderful. good luck on what you decide and keep us posted. ;)