Hi there,

I've been on infliximab for 10 years, and my doctors have consistently been checking the level. They were going through Prometheus Labs initially, but recently the test has been opened up to other places. It's never been covered by any insurance I've had, as it is regarded as "investigational" (which is bullshit, imo) However, with Prometheus I used to qualify for a low-income waiver which halved the cost, as I was not making much money at the time.

I got the test at LabCorp last year, and my insurance said it was not covered - and this time I have to pay $350. I'm not looking forward to paying that much every time I get the test.

I've been on the phone for hours with the insurance company, and I either have to appeal or give it. I'm pretty sure I'll lose the appeal as my EOB is clear - but there's also a second, more independent appeal process if I lose.

Has anyone ever appealed a biologic serum / antibody test? Also reached out to the Jennifer Jaff Foundation to learn more about my options, but I guess I'm not looking forward to putting in all this time and effort just to get rejected, and interested in other's experiences.