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Rheumatoid Arthritis, Medicare and Infusion Centers

Ms Meniscus advises a women concerned about being switched from Humira to an infusion center after she starts Medicare.

I am 50 years old and have had RA since the age of 19. I live in Massachusetts, and I am on Humira which is working very well for me. I am also on Medicaid which pays all but $3.00 of my monthly prescription. I would like to know if when I turn 62 or 65 will Medicaid stop paying for my meds, and will I be forced to go on Medicare and then to an infusion center for my medication? Any help with this would be appreciated.

Thank you,

L R

Dear L R,

You are right to be concerned but you have several years before you have to deal with the problem of being switched when you go on Medicare. Today, your doctor most likely will prescribe an infusion when you reach Medicare age because your copay to stay on your injectible will be much too high.

CreakyJoints does not believe switching drugs is in your best interest. All drugs are not alike and if one particular drug works well for you, the best therapeutic course is to stay on it. Unfortunately, our healthcare system is not always set up to do what’s best for you. But as I said you have a few years before this particular problem hits you, and there isn’t anything you can do now. Pay attention to your immediate needs. Stay healthy, exercise, stay active, and take continue to follow your doctor’s advice. You didn’t say what state you are from, so I can’t say specifically what problems you may encounter before you get to Medicare age, but many states are moving their Medicaid patients to managed care and many of those patients are being switched from one drug to another. Talk to you doctor now and find out if this is a possibility in your state so you can let your doctor know that you do not want to be switched. Also, send me another email letting me know what state you’re in and I’ll let you know what’s happening with Medicaid that might affect you. Also, we’re always looking for smart people who can speak out about the care they receive, good and bad, and this issue is going to be a hot one. If you’d like to help us work with state legislatures and the media to ensure that everyone gets the drugs their doctor prescribes, let me know. If you go to www.failfirsthurts.org you can see the work we’re doing, and the other patients who are speaking out. We’d like to have you in this group. Or better still, fill out our survey if you're on Medicare and you've been switched. 

Be well and stay in touch.

--M

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