Coverage for ulcerative colitis specialists and treatment can depend on your specific health insurance plan and whether healthcare professionals are in your network.
Planning for the future with a chronic condition like ulcerative colitis (UC) can involve navigating insurance coverage and finding doctors who are in-network for your plan, as well as making adjustments to other activities depending on your symptoms.
When you live with a condition that causes severe symptoms like diarrhea, bloody stools, and belly pain, there are many day-to-day issues to manage.
Keep reading to learn about a few other aspects of UC that you need to consider when planning for your future, including shopping for insurance, navigating pregnancy and travel, and finding UC specialists.
If you’re employed full-time with good benefits (or your partner is), health insurance might not be at the top of your worry list. But if you don’t have employer-based health insurance, you’ll need to explore your options.
That may mean purchasing a plan through the marketplace. Under the Affordable Care Act (ACA), health insurance companies can’t deny benefits or charge you more because of a preexisting condition like UC.
If you’re around age 65, you may qualify for insurance coverage through Medicare. This can involve choosing standard government-provided plans for hospital coverage and outpatient medical coverage or comparing Medicare bundled plans from private insurance companies offering similar coverage.
The plan you buy might not cover everything. You may still have to pay out-of-pocket insurance premiums and drug copays. You can talk with a representative at the insurance company before you enroll and ask how much of your medical and drug costs you’ll have to cover.
Also, check the plan’s formulary to ensure the medications you need to manage your UC and any other conditions you have are covered. A 2017 study found that most health insurance policies don’t follow the American Gastroenterological Association’s guidelines when approving biologic drugs, which many people with IBD need.
A 2024 review of research that cites the same 2017 study also notes that some people ultimately get coverage after appealing pre-authorization decisions. The researchers also point out that support programs that work with insurance companies to cover the cost of certain medications may be available.
People with inflammatory bowel disease (IBD) are just as likely to get pregnant and deliver a healthy baby as those without it.
Yet it may be harder to get pregnant if you’re in the middle of a flare. Your doctor might recommend waiting until you go into remission and remain there for a few months before trying to conceive.
If you are trying to become pregnant and taking methotrexate (Otrexup (PF), Xatmep, Rasuvo) or a steroid medication, doctors may recommend you stop taking it 3 to 6 months before conceiving. Many other UC drugs are safe to take during pregnancy.
If you are trying to get a partner pregnant and take the medication sulfasalazine (Azulfidine), you may need to switch to another treatment. This drug can change the sperm and make it harder to conceive.
Treating UC requires a team effort. A primary care doctor usually acts as the point person for general health issues. But you may need to see specialists for different aspects of your care:
- Gastroenterologist: This doctor treats UC and other diseases of the digestive tract.
- Colon and rectal surgeon: This specialist is the one you’ll see if you need surgery to remove portions of your colon and rectum or your entire colon and rectum (proctocolectomy).
- Radiologist: This specialist reads the results of your X-ray, CT scan, MRI, and other imaging tests used to diagnose and monitor UC.
Your primary care doctor may refer you to these specialists, but it’s still important to verify that they are in your insurance network. If they are not, you may need to find a different specialist for the visit to be covered by insurance.
You can travel for work or vacation with IBD.
However, it may require extra planning and precautions.
Before you go, scope out doctors and hospitals in your destination. You can check the Crohn’s & Colitis Foundation’s database for locations in the United States or contact the U.S. embassy or consulate in your destination country.
Bring enough medication to last your whole trip, plus a little extra in case you get stuck at your destination. Also, carry a signed letter from your doctor detailing your need for the medication and your original prescriptions to avoid any hassles from customs officials.
Check if your health insurance policy will cover you if you get sick abroad. If not, you may want to purchase an international policy for your stay.
Bring a kit filled with toilet paper, wipes, extra underwear, and any other supplies you might need for emergencies. Before sightseeing, search online or use an app like Flush or We Can’t Wait to find public restrooms at your destination.
UC is a chronic condition. Its symptoms can come and go over the years. Although there’s no real cure, you can manage your condition with medication, diet, and surgery.
You’ll have the best outlook if you’re an active participant in your care and have a healthcare team you trust. Learn all you can about your condition, and follow your doctor’s treatment recommendations carefully.
See your doctors for regular follow-ups. If your symptoms aren’t well-managed or your treatments cause side effects you can’t tolerate, your medical team can fine-tune your care to help you feel better.
Living with a chronic condition like UC can require a lot of planning.
Your treatment will likely involve a care team made up of multiple specialists.
Whether you use private or government-provided insurance, you may need to ensure your health insurance covers your medications and doctors. Your care team may also be able to file appeals for necessary drugs or direct you to other resources to help support the cost of medication you need.
There may be special considerations for pregnancy or travel with UC, but both are possible with necessary planning.