Insurance question: UHC & Ocrevus?

[anaishunter]

I'm about to take a new job (yeah!).

Have you had a positive or negative experience with United Healthcare and getting Ocrevus treatment approved?

(I was covered by UHC for 9 months in the past and they rejected the dr prescription several times, refused to have the infusion done at a hospital...).

The plan is UHC Select Plus PPO.

Just trying to get input so that I can get ready for what's ahead.

Isabelle.

[carolek572 CommunityAmbassador]

Hopefully your new employer has a great person (benefits coordinator?) that will advocate for you should you have problems with UHC,  anaishunter

I never really had a bad experience with UHC, just a bunch of pain in the neck stuff, but with the benefits coordinator, things got sorted out. This was back in 2000, so I hope that things are better.

[ahrogers]

I don't have UHC but have had 2 different insurance companies cover Ocrevus. I used to get it at my previous neurologist office as he had an infusion suite. My current neurologist had an infusion suite in her old office but when the office moved into a new building that had a separate infusion center, I go there now. I have never needed to go to the actual hospital for it, thankfully.

I am actually getting my infusion today 😊

[anaishunter in reply to ahrogers]

thank you. good luck.

I've had the infusion done in the past 5 years at a hospital infusion center. I felt I was pampered on that day.

[ahrogers in reply to anaishunter]

I definitely feel pampered at the infusion center too. Warm blankets, recliner with pillows and wide selection of snacks and beverages. When I got it at the doctor's office they actually ordered lunch delivered from a local restaurant and I got to pick my meal. Would have to include a massage to be more pampered 🤣

All went well yesterday. I have been getting the rapid infusion the last couple of years so am in and out in under 4 hours. I have only had a reaction once. That was in 2016 when I got my first half dose and it was a mild rash on my face that went away when they slowed the infusion, I didn't need additional Benadryl or anything.

I time my first infusion of the year in January so the copay assistance will wipe out my deductible for the year. That way all my prescriptions and any other care I need for the year is free 😁

I hope you have no problems with UHC.

[Scout4x4]

UHC doesn't cover Ocrevus because it is to be given as a compound medication. Mixing the steroid compound hospital wise costing $140,000. An outside infusion center can do it for $60,000.There is no change in effectiveness. All they do is run the the steroid first by its self and then run the Ocrevus.

UnitedHealth care covers this procedure. It's not a compound med.

[anaishunter in reply to Scout4x4]

thank you for the explanation.

[Cutefreckles72]

I had UHC and they paid for 8 Ocrevus infusions. My husband works for Wholefoods, and they were using UHC but when Amazon bought Wholefoods the insurance changed to BCBS. and they wanted me to do in-home infusion, but I didn't so I use my Georgia Medicaid and go to the hospital. Talk to your HR representative. He or She should be able to help. good luck and Congratulation. 👍

[MarkUpnorth]

I had the insurance for a couple years. Come time for a colonoscopy, checked before, yes covered. They refused to pay. Fought the decision for over a year. Finally had the provider make a change in the code, covered. The aggrevation made me change.