Remember me?Paying $2,660. up front for enbrel??
Yep......that's what I had to do last month and it would have continued that way, paying Happy Harry $2,660. up front and then submitting to our union for reimbursement of $2,100. from them leaving me paying out of pocket $532. a month. I was paranoid I wouldn't have the reimbursement before the next months supply.
Anyway a couple weeks ago I called Enliven. I told my story and the nice man took all my insurance info and said he would get back to me in a day or 2. I really had no hope as harry wanted their money before it went out the door....and the union won't pay till they are billed.
A couple weeks went by with nothing. I went away for 6 days to PA and came home to a copy of a letter from our union to a place called CuraScript in Florida. It stated they (union) agreed to pay 80% of CuraScripts price of....hold onto your hats......$1,294.02 minus 10% for a total payment from them of $931.69 and that the patient (me) would be responsible for 20% for a total of $232.92!!!!!!!!!!!! That's $300. less than I was paying and the union now pays less than half of what they had last month. I couldn't believe my eyes.....had no clue who curascript was or how they reached our union. We have blue cross/blue shield and the union picks up many other things not covered by them. I spent hours on the phone calling my derm, the union...to see who started this and if it was for real. Mainly cause on my way home from PA I didn't even stop at my house but went straight to drop off my renewal to happy harry's, then grabbed the mail....then fell off my seat. I finally contacted Curascript and was told enbrel reached them. As of today, everything is settled but I will be paying a little more than first quoted as that 10% should not have been taken into account. They took my checking info over the phone and my cost is $258.80 a month and the union will pay them direct their share. I am THRILLED!! And so happy but just wish I knew who the man was who started it. Union was thrilled and said they wished everyone would do their homework. My first door delivery is tomorrow and I'm anxious to get back on track as I've been out of shots for a week.
After only 4 weeks on enbrel I absolute see a difference. I can pinch my skin....where it wouldn't budge at all before. It's flatter...almost smooth. The new ones I got after stopping Raptiva on my torso and thighs are vanishing but so is my pigment.
I've had P for 13 years and I mean bad P and I have tried amevive, raptiva, mtx, laser, goeckerman....you name it....and I finally see some hope!
Thanks to all of you who suggested I make that call. Now I'm Happy and Harry isn't!!
Sue in Ocean City, Maryland