Remistart is a medication assistance program provided by Janssen Pharmaceuticals to assist patients taking Remicade with their bills. Remistart provides up to $10,000 of medication assistance in a given year. The intent of the Remistart program is to cover most of the drug costs until a patient's deductible has been met.
As I mentioned earlier, my insurance has a "maximum out of pocket" per year clause. I highly recommend that anyone with a chronic condition look for an insurance plan with a clause like this. My maximum out of pocket costs this year are $10,000.
I've gotten my first bills for my Remicade infusions, so I'll share those with you and show how this all works
Bill for first infusion:
Bill for second infusion:
In tabular format, this is what it looks like:
After these two infusions, I've met my deductible of $3,600 (partially from expenses not shown) and am getting very close to my maximum out of pocket costs for the year with only about $1,900 left before reaching this number.
Remistart has covered $6,138.73 which leaves $3,861.27. My next infusion will consume another $1,997.02 of the Remistart benefit and leaving $1,864.25 of benefits. Since my next infusion will get me to maximum out of pocket benefit, I won't need this remaining benefit.
In summary
My first infusion satisfied my deductible requirements, so subsequent infusions will be covered by insurance.
My third infusion will reach my maximum out of pocket for the year and all other medical expenses will be covered at 100%.
As I mentioned earlier, my insurance has a "maximum out of pocket" per year clause. I highly recommend that anyone with a chronic condition look for an insurance plan with a clause like this. My maximum out of pocket costs this year are $10,000.
I've gotten my first bills for my Remicade infusions, so I'll share those with you and show how this all works
Bill for first infusion:
Bill for second infusion:
In tabular format, this is what it looks like:
Infusion 1
|
Infusion 2
|
|||
Drug
|
Nurse
|
Drug
|
Nurse
|
|
Total Billed
|
$19,920.61
|
$1,200.00
|
$19,920.61
|
$1,200.00
|
Discount
|
$6,573.80
|
$396.00
|
$6,573.80
|
$396.00
|
Insurance
|
$9,200.10
|
$683.40
|
$11,344.79
|
$683.40
|
Deductible
|
$2,523.16
|
$0.00
|
$0.00
|
$0.00
|
Copay
|
$1,623.55
|
$120.60
|
$2,002.02
|
$120.60
|
Remistart
|
$4,141.71
|
$0.00
|
$1,997.02
|
$0.00
|
Out of Pocket
|
$5.00
|
$120.60
|
$5.00
|
$120.60
|
- Italicized numbers count towards my deductible and maximum out of pocket health care costs.
- Bolded numbers are what I must pay.
After these two infusions, I've met my deductible of $3,600 (partially from expenses not shown) and am getting very close to my maximum out of pocket costs for the year with only about $1,900 left before reaching this number.
Remistart has covered $6,138.73 which leaves $3,861.27. My next infusion will consume another $1,997.02 of the Remistart benefit and leaving $1,864.25 of benefits. Since my next infusion will get me to maximum out of pocket benefit, I won't need this remaining benefit.
In summary
My first infusion satisfied my deductible requirements, so subsequent infusions will be covered by insurance.
My third infusion will reach my maximum out of pocket for the year and all other medical expenses will be covered at 100%.
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