Treatment with REMICADE® is covered by most insurance plans, as well as Medicare and Medicaid. Just remember that coverage policies may vary by insurer, by individual, or even between plans offered by the same insurer.
Your insurance coverage can vary for many different reasons, including:
If you have any questions about insurance coverage or reimbursement, you should first call your insurance company or Medicare.
Medicare carriers and the claims processors for all states cover infusions of REMICADE® in doctors' offices and hospital outpatient facilities. The traditional Medicare Fee-for-Service Program does not cover infusions of REMICADE® when they are provided by home infusion companies or retail pharmacies.
Medicaid also covers infusions of REMICADE®, but coverage may be restricted to certain treatment settings or may require precertification.
Most managed care plans—such as health maintenance organizations (HMOs) and preferred provider organizations (PPOs)—cover treatment with REMICADE®. Managed care plans typically require that you share some of the cost of infusion therapies. In general, these plans are likely to require precertification and completion of referral forms for specialist care. They may also limit the choice of providers from whom you may obtain treatment.
These plans usually cover therapy with REMICADE®. Typically, this insurance offers coverage for a wider range of services, but with a higher level of copayment than a managed care organization. Precertification or prior authorization is usually not required.
If you need additional information related to medical coverage for REMICADE®—or if you have other questions or concerns— call AccessOne®  at 1-888-ACCESS-1 (1-888-222-3771) for assistance.
Yes. There are many sources of public and private financial support available to people who need help paying for their medical treatment.
In some cases, certain foundations provide support specifically for people who are being treated for a particular disease.
Only your doctor can recommend a course of treatment after checking your health condition. REMICADE® (infliximab) can cause serious side effects such as lowering your ability to fight infections. Some patients, especially those 65 years and older, have had serious infections caused by viruses, fungi or bacteria that have spread throughout the body, including tuberculosis (TB) and histoplasmosis. Some of these infections have been fatal. Your doctor should monitor you closely for signs and symptoms of TB during treatment with REMICADE®.
Unusual cancers have been reported in children and teenage patients taking TNF-blocker medicines. Hepatosplenic T-cell lymphoma, a rare form of fatal lymphoma, has occurred mostly in teenage or young adult males with Crohn’s disease or ulcerative colitis who were taking REMICADE® and azathioprine or 6-mercaptopurine. For children and adults taking TNF blockers, including REMICADE®, the chances of getting lymphoma or other cancers may increase.
You should discuss any concerns about your health and medical care with your doctor.
What should I tell my doctor before I take REMICADE®?
You should let your doctor know if you have or ever had any of the following:
Also tell your doctor if you:
What should I watch for and talk to my doctor about before or while taking REMICADE®?
The following serious (sometimes fatal) side effects have been reported in people taking REMICADE®.
You should tell your doctor right away if you have any of the signs listed below:
You are encouraged to report negative side effects of prescription drugs to the FDA.
Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.