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 or if you have questions or concerns--call Janssen CarePath at 877-CarePath (877-227-3728) 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.