MS and Stress go Hand in Hand
Written by Ann Pietrangelo on April 6th, 2008 in Health Care Policy, Medications.
Last month, I wrote a post about the difficulty I had in securing my multiple sclerosis medications through my new insurance company. After that horrendous experience, they cautioned me that things may not be easier next time. Well, they got that right.
Month number two with new insurance proved every bit as frustrating. I have no choice in pharmacy for these precious injectable drugs. Insurance company allows but one, and they are an unpleasant group at best. They still wanted to charge me more than my maximum monthly out-of-pocket. Interestingly, they wanted to charge even more than the previous month.
Not receiving the promised return phone call, I had to brave the voice mail system once again to speak to a customer service rep. Both she and her supervisor, insisted that I was wrong… that it is entirely my problem… that they would not contact my insurance company to straighten this problem out.
A series of frustrating calls… and days later, my meds were ordered up at the correct co-pay. When I asked the representative from my insurance company if this would be rectified before next month’s supply is needed, I was told that no, it probably would not. So sorry, and all that…
So, next month we get to play this game all over again. First shell out $1,100.00 per month — minimum — then fight, plead and beg to get your much-needed medications. Ain’t it grand?
How many times have we been given the advice from doctors, friends, and even strangers, that we must learn to reduce stress so as not to aggravate our MS?
To all those well-meaning folks out there, the reality is this. If you have a major health condition such as MS, and you do not have access to group health insurance, you are in for a world of stress.
April 6th, 2008 at 7:46 pm
I am so sorry that you have to go through this. This must be so frustrating.
This just reminded me to look at health care policy before I vote in the fall.
April 6th, 2008 at 10:12 pm
Mandy,
Here’s a comment I left on another blog recently in response to finding assistance for Copaxone. Since I don’t know exactly what income range you and Jake are in, I am unable to narrow down this list (sorry). I imagine that as freelancers you guys have maximized deductions and such which is VERY important in lowering that AGI. If you have debt of any kind, that also helps in receiving help from NORD but not from the other programs. I hope that this might help.
1. Call Shared Solutions 1-800-887-8100 as they need to refer you to NORD. You will need to speak with their “benefits department” so that they can run a search on any other programs available in your state. Now you might run into difficulty since the new insurance is not actually in effect yet. But I’d try anyways. When they determine that you will have a “high co-pay” then NORD comes into the picture.
2. Try calling NORD directly 1-888-211-6650. This is the number for their “Copaxone Medication Assistance Program” which is the one I have been through and requires the submission of a great deal of financial information. (oh, btw, if you get Pam or maybe it’s Pat on the phone, be really nice because she’s a pain in the tookish and not too sympathetic)
3. Call Patient Access Network Foundation (www.patientaccessnetwork.org) 1-866-316-7263 which specifically assists insured patients with out-of-pocket prescription costs. At the time I applied, they only required proof of income (no bank statements) to determine eligibility. However, I earned about $5000 too much although I was looking for help with $10,000 of medication. Currently, their MS program is open for new applicants.
4. Call the Chronic Disease Fund (www.cdfund.org) 1-877-968-7233 also helps insured patients with out-of-pocket prescription costs. I do not know their income requirements, but they do state that they are based on median incomes (not the same as FPL incomes).
5. For generic meds which are not included on the Wal-Market/Target $4 lists, contact Rx Outreach (www.rxoutreach.com) 1-800-769-3880. There will be a $20-40 cost for a 3-month supply for each prescription, but the eligibility requirements and application are SUPER EASY to complete. I have been thrilled with their program.
6. And finally, the most important resource to be aware of…
Needy Meds (www.needymeds.com). Here you will find the most comprehensive resource for available assistance programs, organized by specific disease, by drug, by state, etc. Hands down the Godfather of prescription assistance – forget the Partnership for Prescription Assistance (a waste of time and effort) or the other similar sites. Needy Meds is always the first stop in any search.
If there is anything else I can do to help, please don’t hesitate to contact me.
Lisa
April 6th, 2008 at 10:29 pm
Vered,
Thank you for that comment about voting and health care policy. We’ve got to make some changes and what better time than election 2008?
April 7th, 2008 at 8:43 am
I’ve seen this game played before … if you get the ‘clients’ to quit trying to be serviced … they reap (rape) the benefits.
Watch the first 30 minutes of the “Incredibles” movie.
April 7th, 2008 at 6:36 pm
Dang it all that hassle and those with MS cannot handle this kind of stress. Insurance supposed to help, not give us a hard time.
Jim
April 9th, 2008 at 1:20 pm
AMEN! AMEN! This has been the first year in as long as I can remember that I have not spent a full-time, part-time job trying to resolve Patti’s prescription plan payments and co-pays usually through May each year before ‘they’ would get it right only to come all unglued when the year began again. Over the years any change in carrier, etc would only extend the battle. Years earlier when Patti still tried to deal with it herself, and/or her MS cognitive abilities were fading it would become absolutely confounded. … Personally I have come to believe it is standard operating procedure. After all if ‘they’ can drive you to give up, then they are accomlishing their objective to not pay.
Caregivingly Yours, Patrick
http://journals.aol.com/daddyleer/CaregivinglyYours/