Blue Cross is paying for my Enbrel!!

** Originally posted by NL **

Even with my pre-existing condition clause, it does not apply to medications. My cost will be $15-30 co-pay (I guess I don't know if that's per shot or month or what??). I'm excited, scared, happy..... I have searched the board for Enbrel many times but I would love to hear from people on Enbrel or just starting out.

I'm praying this is the drug for me....I have never experienced "clearing" and would give just about anything to.

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** Originally posted by Caki **

Did you take MTX first? Blue Cross will not pay for Enbrel unless I go on MTX first and I don't want to. Congrats on your news! I hope it works well for you and I will be very interested in hearing about your experience as I'm sure some others will be.

Good thoughts and best wishes!

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** Originally posted by NL **

Caki,

I have tried MTX, Cyclosporin, UVB, tons of topicals and the "altnernative" approach. MTX gave me some relief and I didn't have any side effects - except for maybe being tired. I did have my blood tested every week and took Folic Acid. I also treated myself good and avoided getting sick at all costs. It just wasn't the answer for me.

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** Originally posted by Caki **

NL, thanks for the information. I have P and PA. No breakouts right now, but I had an awful flareup of the PA a few weeks ago. I got an injection to get me through some trips I had to take, but now I have to decide on the long term drugs or where to start. I don't want to take MTX. My doc wants me too, but I'm willing to try sulfasalazine to start. If that doesn't work, I would like to go to Enbrel, but I need to figure out how to get that paid for without going on MTX. Heck,if I can do that, I'd try Enbrel first. We'll see what happens on my next appt, I assume. I don't have one scheduled yet. I'm holding off while I feel good. You know, putting it off for as long as possible!

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** Originally posted by NL **

Alli,

I hope I'm a text book example too. Do the 50 mg shots hurt as bad as everyone says? I'm a needle whimp, for real. I decided I will put up with it to have a "stab at" getting rid of P. My boyfriend is going to have to give me the shots, I still don't look when the nurse takes blood. I hope he is ok with it.

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** Originally posted by NL **

Thanks for the replies. I have a feeling I'm going to need a lot of hand holding...... :rolleyes:

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** Originally posted by JillyBean **

Congrats on getting to start Enbrel. You sound like me 3 weeks ago when I started. I was very lucky, BCBS is covering my Enbrel and I did not have to try MTX - I wouldn't have. I did fail PUVA though for 6 months and my feet look so awful and painful (the derm sent in pics) so maybe that helped. I was also very intimidated and nervous about the shots and I can tell you it's not that bad at all! I don't look when they take blood. This is much easier. You are not going anywhere near a blood vessel, just under the skin. I was so excited when I did my very first shot on myself and it wasn't hard. If you do it right (haver your nurse show you) and "dart it" - just stick it in all the way at 45 degrees without stopping, it doesn't hurt at all going in. It's pushing the drug in that hurts. It stings like a bee sting. Not too bad, but def. uncomfortable. I had my nurse give me my shot at each site on the right side (e.g. right thigh, right stomach, right arm) and then I had her watch me inject myself on the left sites. That helped me get comfortable. My boyfriend had to do my arm, I can't reach to pinch and shot at the same time! Best of luck to you!!!

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** Originally posted by PJ66 **

Alli,

I hope I'm a text book example too. Do the 50 mg shots hurt as bad as everyone says? I'm a needle whimp, for real. I decided I will put up with it to have a "stab at" getting rid of P. My boyfriend is going to have to give me the shots, I still don't look when the nurse takes blood. I hope he is ok with it.

Hi,
I was a real needle whimp as well. in the beginning I had to get someone to help me get the needle in. I was ok once it was in. I would then take over and push the medicine in myself. That way if it starts to hurt I can stop or push slower. I now do the shots completely myself. If you ice the area for 5 minutes before you inject it, you don't even feel when you stick the needle in.
Polly

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** Originally posted by mdgirl **

NL,

Polly was great in coaching me to do my shot. I was like you...........I throught these people must be crazy thinking that I am going to stick myself with anything.

The reason I got Polly to help me is because she was a big chicken like me. But I can do it now....tomorrow will be shot number 10.

We are here if you need us.

Take care,

Diane

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** Originally posted by PJ66 **

NL,

Polly was great in coaching me to do my shot. I was like you...........I throught these people must be crazy thinking that I am going to stick myself with anything.

The reason I got Polly to help me is because she was a big chicken like me. But I can do it now....tomorrow will be shot number 10.

We are here if you need us.

Take care,

Diane

Diane,
Thanks, I think. Ok, yes, i was a BIG chicken about the whole thing. You made me laugh so hard when I read that. I was glad to help you get through it.

NL,
Diane is right. We will help you in anyway that we can to get you through it as well. We know how scary and hard it is to do. Heck it took me months just to say yes to trying it. My dr. was really nice about it. He told me to take my time and think about if I would try it or not. Don't be afraid to ask us for help.
Polly

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** Originally posted by NL **

Thanks everyone. The Enbrel will be in the pharmacy on Tuesday. I can't go in to the doctor to learn how to inject it because Blue Cross won't cover that. I'm thinking about calling the Enbrel hotline and having a nurse talk my boyfriend and I through it. Anyone else do that?

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** Originally posted by JillyBean **

I think you really should have a nurse help you with it the first time at the very least. I don't think my nurse charged me to go in and have her show me how to do it. I let her inject me my first shot and was glad I did. That way I knew what to expect when I gave myself the second shot. Please call you doctor's office and arrange to have someone help you. Let us know how it goes and good luck!

Jill

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** Originally posted by tanya01 **

How did you get them to cover it? As I sit here I am waiting for my pharmacy to fax the auth. form to my Dr. so he can fax approval to my ins. co. BC/BS but it's a PPO. They won't cover it if they think it's for "cosmetic" reasons. What a crock! I'd like to see one of the insurance reps live with this for just 1 hour, then go out in public wearing shorts and short sleeves so the whole world can point and fire the "Oooo, what happened to your legs?" questions. Hopefully my Dr.'s request to them will be answered and I will have my Enbrel before the weekend. I also tried Methotrexate several years ago and it didn't really work. I can't stand having blood drawn either and I was so afraid of what else it was doing to my body; that stress alone made the P evern worse. I used Enbrel about 2 years ago and IT WORKED!! I was completely clear for almost 1 1/2 yrs. I injected it into my stomach; I just pinched an inch and jabbed it in! No pain at all really! Good luck to you!

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** Originally posted by JillyBean **

Tanya,

I was fortunate that Blue Cross of FL - a PPO, covered my Enbrel. I had already tried numerous topicals and 6 months of PUVA. My doctor and nurse took pictures of my feet - they are really bad and it's easy to see how painful walking is - and filled out the paperwork and sent it to my insurance and pharmacy company. Good luck to you, I hope it is approved!

I do have to have my blood tested every month at my doctor's insistance to make sure everything is OK. Luckily I have had so much bloodwork it's not a big deal anymore.

Jill

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** Originally posted by tanya01 **

That's good to know; the last time I used Enbrel ins. covered only part of it, still cost about $600 a month. They want me to do Methotrexate but my Dr. knows that it doesn't work for me; hopefully that's what he will tell my ins. co. All I want is to enjoy my summer for a change; I want to wear shorts and sleeveless shirts and not be pointed to, gawked at and questioned. I've even told children to mind their own business when they ask about my skin. Another point to argue with the insurance co. is that if they DON'T approve Enbrel then I will need to be treated for depression also; the worse my skin looks and feels I feel myself slipping into that hole again. I'm impatiently waiting my Dr.'s office call; they have the forms in hand, just need to convince my ins. that I NEED this!

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** Originally posted by NL **

Tanya,

I am counting my blessings. I called Enbrel and told them about my pre-existing condition. They offered to call Blue Cross for me. The next day Enbrel called me back and told me it was covered. She said my case was one of the "easier" ones. Seeing that I have a pre-existing clause, BC has access to all my medical records. I don't know if they looked at them, but if they did they would see everything I have tried and how long I have been dealing with this. I really don't know how it worked out so easy.

JillyBean, you are making me nervous, a little. You really don't think a nurse could walk through it with us on the phone??

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** Originally posted by NL **

OMG---I just called Walgreens and it's in!! I'm soooooooooo nervous. I know I must sound like an idiot. Funny, BC woun't cover the Clobex (sp?) spray which is fairly new.

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** Originally posted by tanya01 **

NL,

It's really not as hard as it sounds. When you open the instruction booklet, it will freak you out a bit! I had my Dr. show me the first time; I was more afraid of "mixing" it wrong (the instructions make it seem VERY complicated). Enbrel is not supposed to be injected into a vein, rather just any part of your body with a little fat will do! I chose my side or my stomach because it was easy to just grab about an inch of flesh and kind of poke it in sideways; plus I knew there were no veins close by. I can honestly say I couldn't even feel it going in. It's much easier to mix than the instruction booklet says, too. Although I know some Enbrel shots are pre-mixed (not sure what kind you will be getting). Also, you may want to go to a lab where they draw blood, they may be able to help you because most people don't need an appointment for blood work. Hope this helps!

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** Originally posted by dcrabtree **

NL, needles suck, but do it baby! Sticking myself and my wife with humira every 2 weeks has been a blessing for the PA & P that I have. The med will probably come with an instruction sheet on how to do it...the few minutes of needle pain outweigh the hours/days of P & PA pain.

Caki, why don't you want to go on MTX? Once a week, before bedtime is when I take mine...no noticeable side-effects, take folic acid daily...

peace n love everybody~ :cool:

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** Originally posted by NL **

Actually my boyfriend did it. It wasn't bad at all. What was bad was thinking about it hours before we did it. Icing the area really helped. The injection spot is a little tender today, nothing bad. Thanks for all the tips!! Come on clear skin.................

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** Originally posted by PJ66 **

NL,
WAY TO GO!!!!! glad to here you got through the first shot. Best of luck to you. Keep us updated.
Polly

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