#insurance problems

If you’re in America like me, I’m sorry. Things are a bit tough and scary right now. I’m seeing a lot of people asking for help for paying for medicines and medical procedures, either because they have no insurance, or what insurance they have sucks, or whatever new way they’ve found to screw you.

Don’t despair. I’m with you.

I was paying $400 a month for insurance in 2015 when I was hospitalized with DKA. That is, I was Type 1 Diabetic and didn’t know it. I almost died, and when I made it to the pharmacy after to get my insulin, I was kinda wishing that I had.

$900+ for insulin. Two insulins, both needed to keep me alive. Weak and exhausted, I broke down at the Walmart pharmacy counter. 

But my mother was with me. She held me as we both cried, then she got up and started searching on the internet.

See, drug companies know they’re shit, cause they can give their drug away if you know where to look.

Help Paying For Medicines: Discount Cards

First step, find out who makes your meds and go to their website. You can even just do a Google search “***** discount” -or “**** discount card*. 

For instance: Lantus, made by Sanofi. Type in “Lantus discount” and the first link is their website, with links to sign you up for a discount card.

https://www.lantus.com/sign-up/savings-and-support

It costs $400+ per box of pens. With the discount card, it costs me nothing.

Now, your mileage may vary. Most of the times before, it cost me $45 per box, which is still steep, but it helps. No idea why the amount changes. I’m sure there are mysterious heathcare industry reasons.

Help Paying For Medicines: Make the Call

Y’all gotta get over your fear of making phone calls. It could kill you.

If you can’t find online discounts for your drugs, call the manufacturers themselves. You may be on hold for a while. It’s worth it.

Back in the 1990s, a new drug called Enbrel was released for rheumatoid arthritis. Before that, they just gave you some Tylenol and told you to suck it up.

My father needed this medicine. Problem: it was $2000~ a month. $350, with insurance. 

Now, we were poor Midwesterners. $350 a month just less than the mortgage was. We paid that for years. It was bad. 

Then, one day, my mom called the manufacturers. She got a discount.

$20 a month. For a medicine that cost $350 a month with insurance. For a medicine that retails for $2000 a month. 

Make the call. It might not work out, but you have to try.

Paying for Medical Procedures: Mortal Kombat

I like games. They’re an escape and a release from the stresses of the day.

I hate playing games in real life.

Which is what you’re force to do when dealing with health insurance in this country.

You have to call. You have to ask questions. You have to fight.

If you’re bill is higher than you can comfortably pay, call your insurance company. Ask about every single charge. Tell them you’re having trouble, tell them you’re money problems. 

It might work. It’s worked for me before 

But it might not. You have to try.

Also, call the place where the procedure was done. Tell them your problems, tell them your money troubles.

They want your money. They’ll take whatever money they can get. 

Sometimes they’ll only put you on a repayment plan. But that way, you won’t be getting notices from them, screaming about how they’re going to send your account to collections.

Sometimes they’re drastically reduce your payment so that you can repay in full now.

Either way, do it. It’s exhausting and frustrating, but it’s so worth it.

In Conclusion 

It sucks, I know. And few if any of these options may help you. There’s so much variation in doctors, drugs, procedures, medical offices, state laws, federal laws etc. 

But once upon a time, I didn’t know about any of these. They count on you not knowing, or being too busy, or thinking that it’s too much trouble.

Don’t let them win.

Story of my life. Going to vent out. So I go to Walmart pharmacy close to 6pm to pickup my prescription. I walk up and give my birth date after a 15 minute wait in a very long line. I am told to go to drop off as there is something going on that needs resolved. I turn around the drop of line is long as well. I do my waiting and Dagney, pharmacy technician who's dealt with my struggles calls me up. One of my prescriptions, medicaid did not want to cover paying cash would be $20 which wasn't an issue. Had to fill out a form for pharmacy records. The problem with my other prescription was they were having problems with filling as dosages did not match up with the current prescription. I explained to her i was instructed a week ago to take 100mg x3 daily. They were looking at my old records and the last prescriptions they had for Dantrolene(muscle relaxer) was one prescription of 25mg x3 daily and another 50mg x3 daily. It was 7pm then and I informed them that my doctors clinic is still open. With that said she called. Fortunately she got a hold on someone who was able to verify and authorize the 100mg x3 daily. I knew the waiting estimate if 15-20 minute pick up wait so I sat down and waited. My father who was waiting in the parking lot showed up and asked if everything. I explained the problem and said soon my meds will be ready. An additional 30 minute wait happened, Dagney walked up to me and asked how long have I been taking Dantrolene and if I changed insurances after starting it. She stated insurance does not cover it. I explained I received a letter from my insurance that it would not cover for 2019 but they could make an exception if my doctor stated my conditions as to why I needed to take it. My doctor made the statement and sent the letter. I did not receive any letter back so I thought it went through. I asked Dagney how much it would cost. She left and later informed me it would be $298.00 I told here well I will have to pay it, I just cannot stop taking the medication and I need it. She then offered me a temporary solution to pay for a three day supply and she will try to get a hold of my insurance and see if she could get through with them. Some weight was lifted from my shoulders. I paid and finally after 2 hours left. I am running out of options and its just frustrating. I am tired of everything. Tomorrow ill have to inform my doctor about all if this which is something she will not like. I am a complicated case.

Insurance approved only my hand/wrist splint which I am glad it covered at least one instead of nothing, and I really needed a new one as the Velcro was not holding together anymore.

Medicaid did not cover my shoulder/shoulder-blade stabilizer brace nor my knee brace. Tammy informed me that they work with a company called Ottobock and she found a shoulder/shoulder-blade stabilizer brace that will work with me. She took measurements again and printed out the brace information.

She did mention it’s on the pricey side. My mother and i agreed it did not matter as I needed it to prevent my shoulder and shoulder-blade from twisting inwards permanently and the pain.

It never ends…Ocrevus infusion postponed continued

So yesterday morning I’m sitting here and I get a call from my insurance that the expedited review for ancillary services, a.k.a. the infusion, has not been deemed necessary. Therefore the review will be conducted at the usual standard time as per policy. WTF???? I thought the problem was they didn’t order the drug? Turns out they never got authorization to get the drug or to administer it.

Autho…

Why is it so motherfricking hard to get a wheelchair through insurance. I’m struggling to get by and function with a cane and heavy ass and broken wheelchair from Rite Aid and I’ve been jumping through hoops for months trying get insurance to approve the wheelchair I need. My medical conditions don’t automatically qualify as needing mobility aids so i have to get every doctor and their cousins to verify my need. And my old PT won’t send my records over because she has something against me. And no new PT will see me for an evaluation because I don’t actually need PT just proof of disability.