Infusion therapy for IBD treatment
Published: November 23, 2021
If you have Crohn’s disease or ulcerative colitis, infusion therapy may become part of your treatment regimen to manage your disease. There are many ways you can receive your infusion therapy – read on to learn more about how infusion therapy may be used to treat IBD, your options for where to get an infusion, and how to get information about insurance coverage.
What is infusion therapy?
Infusion therapy involves receiving medication or fluids through a needle or catheter, usually intravenously. Some patients with IBD receive infusions containing medication on a regular basis, and others may need infusions to replenish nutrients such as iron or manage dehydration.
Infusion therapy may take place in a variety of settings. According to the National Infusion Center Association, there are four categories of infusion centers – office-based, hospital-based, pharmacy-based, and stand-alone. Depending on your insurance coverage, you may also have the option to receive your infusion at home. Patients who are taking biologic medications via infusion therapy receive their medication at regularly scheduled intervals determined by their type of medication and the status of their disease.
Will my insurance cover infusion therapy?
Most commercial and public health insurance plans available in the U.S. cover infusion therapy, although not all plans offer the same level of coverage. Some plans specify which medications they cover, which could limit options for a patient who requires infusion therapy. Any costs that are not covered by health insurance may become the financial responsibility of the patient.
If you have health insurance, you can find out what your plan covers by calling the member services number on the back of your insurance card to discuss what treatment options are covered under your plan with your insurance provider.
How can I receive financial assistance to help pay for infusion therapy?
Patients who are uninsured or whose insurance does not cover a lot of the cost of infusion therapy have a few options to get assistance for out-of-pocket costs. The manufacturers of drugs that are given to IBD patients via infusion therapy offer patient assistance programs for uninsured patients. For private and commercially insured patients who need financial assistance, these programs are offered as copay cards.
Patient assistance programs provide treatments for free or at a reduced cost to patients who qualify based on financial need. Usually, patient assistance programs only cover the cost of the treatment itself, and not any supplies or administrative fees. You can use our financial assistance search tool to find programs you may be eligible for. Copay cards help patients who have insurance but need assistance covering the costs associated with infusion therapy that their insurance plan does not cover. Copay cards are available through select pharmaceutical companies who manufacture treatments used in infusion therapy. Patients can apply online for a copay card or have their healthcare provider give their information and prescription directly to the drug company.
Additionally, there are nonprofit organizations, such as NeedyMeds, that offer additional information. Others, like the PAN Foundation, Good Days, and the HealthWell Foundation, may help patients cover costs associated with copays, drug administration, supplies, insurance premiums, and additional fees. To receive a grant from one of these organizations, patients usually need to provide proof of financial need.
The best way to optimize the likelihood of your insurance company covering the cost of your infusion therapy is to work with your healthcare provider to determine the best treatment option for your diagnosis, considering which drugs are covered by your insurance company and have clear documentation to support this medically necessary treatment decision.
If you are denied coverage for your medication, you can contact our IBD Help Center at [email protected] or 888MYGUTPAIN for additional information and resources to help your appeal the decision, including our appeal letters.
Michelle Lampariello is the social media and content manager for the Crohn's & Colitis Foundation.
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