Uff that sucks. Hopefully someone has better advice, but I wonder if someone in a Crohn’s disease organization could help with some advice. I would generally not recommend moving without something lined up for work. You could also try to stock up while here so you at least have a bit of a reserve.
Ah I think by stock up you actually meant stock up on the medication. Unfortunately it is administered intravenously by hospital staff and I don't think they'd let me keep an extra supply :-/
Oh shit, sorry I didn’t realize that. I know people do go to Mexico for insulin which is a similar administration, but I’m unsure of the legality, logistics, or safety of that.
Not sure if infusion meds can be ordered from Canada (used to get infusion drug) and my hmo shipped it to my home (where it could sit on porch) then I’d bring it with me to hospital
I have plenty of money saved up. Enough to last 14 years with my usual expenses in London. So I have plenty of time to find a job. Not concerned about money for normal expenses, but the medication costs $80k/yr out of pocket in the US.
I was going to say this, too. Los Angeles and San Diego would be perfect for this situation. I've been going to mexico for all my expensive medical procedures since I was a child. We started going because my parents couldn't afford my medication here.
Is it an immunosuppressant? Can you find generic versions? Also, 80K a year even with a job that has good insurance? It is truly fucking evil to charge someone 80K a year just to get the meds they need!!
So sorry you’re having to deal with this(another USA person in USA who used to be in uk) fwiw years ago had infusion med and us insurance and even then it was a clusterf to get it all coordinated :( would like to think that’s improved but?? And as far as other meds even with full Medicare and Bcbs can’t use my insurance drug plan to pay for meds as it’d b cost prohibitive so I have to use coupon sites (so my med spending doesn’t even count towards deductible ) sorry to be so glum on it and fwiw you know that Just one med can cost 4k mo :(
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Do you have friends or family in the area you’ll be moving back too? Could you use their address to buy a marketplace policy?. Make sure you check your co insurance rates , biologics are not cheap drugs though remicade now has lots of bio similars which are more affordable and easier to get prior authorization for. However even with insurance, and if you get your last infusion right before you leave, it maybe difficult to see a GI get a prescription and prior auth done and approved before your next due date. Whether that’s an issue depends on the severity of the disease and whether your body reacts to not getting the infusion.
If you can afford to pay out of pocket at first insurance is irrelevant, you’d just have to find a GI doc then pay the bills as they come in. However new insurance and new doctor may mean they want a lot of assessments done prior to filling which will add up.
This seems right. I would likely not be moving back to relatives but I do \_have\_ relatives that live in another state. Do you think it would be possible to move to CA but use my relative's address in CT to buy a marketplace policy? Or will I somehow need to receive mail / prove residence?
Maybe I could find a GI I could get setup with mostly by email / remotely before moving... though I am a bit skeptical this would work.
The american health insurance laws are not my strong point but i think your policy has to be for the state you are in. A PPO will let you go out of state, but a HMO is restricted to instate except for emergencies or a child on the policy who has moved away. I think buying a marketplace policy in one state and looking for care in another would be difficult.
I would however find a good GI in advance and figure out how your records can be sent. With no records or diagnostics doctors are unlikely to just prescribe a drug.
My experience is the opposite my daughter moved to the UK from the US, it took a year to get her back on her biologic.
Yikes. I'm really sorry it took so long to get back on the biologic in the UK. When I moved here from the US I was extremely worried about getting back on it, but I managed to get it on schedule the very next month. I asked my US GI to write letters stressing the urgency that I get the treatment and brought a big envelope full of medical records with me, and I spent A LOT of time contacting people all around the NHS to get it. I just hope I could manage it back in the other direction.
How did your daughter do in the year without it? I'm very worried I'd just not be able to have a normal life anymore and a GI previously told me that if I go too long without it, there is a risk it would not work again when I tried it again.
We bought ourselves about 4 months by getting a dose before she left and taking a dose with her, then i ordered a dose and mailed it.
She made a lot of noise, found a gp, got a referral to GI, made trips to the ER, made her case but the issue was i think, that she was on stelara having already failed remicade and humira, so it’s way more expensive and a case had to be made for it and it had to be allocated in a budget. She got there in the end.
Health wise she struggled, several long A&E visits knowing they probably can’t help but being admitted may move things quicker. She was on Steriods, endocort i think, and did a liquid only diet for several months which also helped.
If you are on remicade and taking a break causes problems restarting you probably can switch to humira or stelara if you haven’t failed them already.
Is it possible to have a job lined up before moving so you can just hit the ground running with employer insurance?
>i think your policy has to be for the state you are in
This is correct, health insurance is prohibited from selling across state lines, it's one of the key weaknesses (among many) of American healthcare from a pure business perspective.
Lurking here but even in boston which regards self as medical Mecca GI appts booking six months one year in advance for existing patients
FWIW too ill to attend my last gi appt in Feb(next avail is in sept for existing patient ;-(
Couldn't you buy 60 days of travel insurance to cover a period back in the USA (take new meds with you from uk to cover the crohns meds in that period) and then use the 60 days to find a job?
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The situation sucks, sorry to hear. i empathise. i assume you've checked out US Affordable Care Act (aka Obamacare) marketplaces. in some states, you can sign up on arrival, and based on income limits qualify for subsidies. Assuming your UK earnings have gotten the Foreign Earned Income Exclusions, your US Tax return adjusted gross income could make you eligible for subsidies. In Massachussets i hear that one qualifies for subsidies 1 month after arrival. You could ask the company patient services line for interim coupon rates (low rates) for a few months. The problem as you and others have mentioned is that this is available only by prescription and specialists are booking out for new patients about 9 months out (people seem to complain about NHS, but the US is no different!).
Moi - on the verge of going to UK on SWV with spouse who needs some prescription oral meds for anxiety/depression related disorder. Fingers crossed care is available in NHS when we need.
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Uff that sucks. Hopefully someone has better advice, but I wonder if someone in a Crohn’s disease organization could help with some advice. I would generally not recommend moving without something lined up for work. You could also try to stock up while here so you at least have a bit of a reserve.
Ah I think by stock up you actually meant stock up on the medication. Unfortunately it is administered intravenously by hospital staff and I don't think they'd let me keep an extra supply :-/
Oh shit, sorry I didn’t realize that. I know people do go to Mexico for insulin which is a similar administration, but I’m unsure of the legality, logistics, or safety of that.
Not sure if infusion meds can be ordered from Canada (used to get infusion drug) and my hmo shipped it to my home (where it could sit on porch) then I’d bring it with me to hospital
I have plenty of money saved up. Enough to last 14 years with my usual expenses in London. So I have plenty of time to find a job. Not concerned about money for normal expenses, but the medication costs $80k/yr out of pocket in the US.
Honestly, Mexico?
I was going to say this, too. Los Angeles and San Diego would be perfect for this situation. I've been going to mexico for all my expensive medical procedures since I was a child. We started going because my parents couldn't afford my medication here.
Is it an immunosuppressant? Can you find generic versions? Also, 80K a year even with a job that has good insurance? It is truly fucking evil to charge someone 80K a year just to get the meds they need!!
Yep it's an immunosuppressant. Yes the people selling it are also evil.
So sorry you’re having to deal with this(another USA person in USA who used to be in uk) fwiw years ago had infusion med and us insurance and even then it was a clusterf to get it all coordinated :( would like to think that’s improved but?? And as far as other meds even with full Medicare and Bcbs can’t use my insurance drug plan to pay for meds as it’d b cost prohibitive so I have to use coupon sites (so my med spending doesn’t even count towards deductible ) sorry to be so glum on it and fwiw you know that Just one med can cost 4k mo :(
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Do you have friends or family in the area you’ll be moving back too? Could you use their address to buy a marketplace policy?. Make sure you check your co insurance rates , biologics are not cheap drugs though remicade now has lots of bio similars which are more affordable and easier to get prior authorization for. However even with insurance, and if you get your last infusion right before you leave, it maybe difficult to see a GI get a prescription and prior auth done and approved before your next due date. Whether that’s an issue depends on the severity of the disease and whether your body reacts to not getting the infusion. If you can afford to pay out of pocket at first insurance is irrelevant, you’d just have to find a GI doc then pay the bills as they come in. However new insurance and new doctor may mean they want a lot of assessments done prior to filling which will add up.
This seems right. I would likely not be moving back to relatives but I do \_have\_ relatives that live in another state. Do you think it would be possible to move to CA but use my relative's address in CT to buy a marketplace policy? Or will I somehow need to receive mail / prove residence? Maybe I could find a GI I could get setup with mostly by email / remotely before moving... though I am a bit skeptical this would work.
The american health insurance laws are not my strong point but i think your policy has to be for the state you are in. A PPO will let you go out of state, but a HMO is restricted to instate except for emergencies or a child on the policy who has moved away. I think buying a marketplace policy in one state and looking for care in another would be difficult. I would however find a good GI in advance and figure out how your records can be sent. With no records or diagnostics doctors are unlikely to just prescribe a drug. My experience is the opposite my daughter moved to the UK from the US, it took a year to get her back on her biologic.
Yikes. I'm really sorry it took so long to get back on the biologic in the UK. When I moved here from the US I was extremely worried about getting back on it, but I managed to get it on schedule the very next month. I asked my US GI to write letters stressing the urgency that I get the treatment and brought a big envelope full of medical records with me, and I spent A LOT of time contacting people all around the NHS to get it. I just hope I could manage it back in the other direction. How did your daughter do in the year without it? I'm very worried I'd just not be able to have a normal life anymore and a GI previously told me that if I go too long without it, there is a risk it would not work again when I tried it again.
We bought ourselves about 4 months by getting a dose before she left and taking a dose with her, then i ordered a dose and mailed it. She made a lot of noise, found a gp, got a referral to GI, made trips to the ER, made her case but the issue was i think, that she was on stelara having already failed remicade and humira, so it’s way more expensive and a case had to be made for it and it had to be allocated in a budget. She got there in the end. Health wise she struggled, several long A&E visits knowing they probably can’t help but being admitted may move things quicker. She was on Steriods, endocort i think, and did a liquid only diet for several months which also helped. If you are on remicade and taking a break causes problems restarting you probably can switch to humira or stelara if you haven’t failed them already. Is it possible to have a job lined up before moving so you can just hit the ground running with employer insurance?
>i think your policy has to be for the state you are in This is correct, health insurance is prohibited from selling across state lines, it's one of the key weaknesses (among many) of American healthcare from a pure business perspective.
Lurking here but even in boston which regards self as medical Mecca GI appts booking six months one year in advance for existing patients FWIW too ill to attend my last gi appt in Feb(next avail is in sept for existing patient ;-(
Couldn't you buy 60 days of travel insurance to cover a period back in the USA (take new meds with you from uk to cover the crohns meds in that period) and then use the 60 days to find a job?
AFAIK travel insurance usually does not cover pre-existing conditions which this is.
Good point you'd need one that did. Ours with Nationwide Bank Plex account does if you disclose it and they a)agree and b)you pay extra.
I never would have thought that there was a travel insurance that would cover this! Thanks.
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And policies even within same states vary by zip code so just moving from town to town means one policy might not be sold in your new location
The situation sucks, sorry to hear. i empathise. i assume you've checked out US Affordable Care Act (aka Obamacare) marketplaces. in some states, you can sign up on arrival, and based on income limits qualify for subsidies. Assuming your UK earnings have gotten the Foreign Earned Income Exclusions, your US Tax return adjusted gross income could make you eligible for subsidies. In Massachussets i hear that one qualifies for subsidies 1 month after arrival. You could ask the company patient services line for interim coupon rates (low rates) for a few months. The problem as you and others have mentioned is that this is available only by prescription and specialists are booking out for new patients about 9 months out (people seem to complain about NHS, but the US is no different!). Moi - on the verge of going to UK on SWV with spouse who needs some prescription oral meds for anxiety/depression related disorder. Fingers crossed care is available in NHS when we need.
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