The Vent and Rant Thread

[badgoodDeb]

He didn't say it was a generic for the same thing .... I interpretted that a different drug had gone generic, and they wanted him to try it ... again.... even though it already hadn't worked before.

[kennyc]

Originally Posted by poohbear_nc

Ok - I just have to type this out to get it out of my system - and stop having an upset stomach ...

As many of you know, I suffer from migraines. Anyone who has experienced migraines knows that "suffer" is the operative term. After literally years of medical evaluation, treatment, and pain control/alleviation programs, I finally found the one perfect medication for me - it knocks out an oncoming migraine in 20 minutes with tolerable side effects. For me - nirvana (of sorts).

Well, last year one of the hundreds of currently available migration medications became available in a (cheaper) generic form. My health insurance company insisted I switch to it or else they wouldn't cover migraine med costs anymore. So I switched to it (I had tried it in the past - it didn't work) - and again proved it didn't work, and had my doctor file a medical exemption form with the insurance company, and, after several months of agony, got to take my proper med again.

Well, this year,
1. The insurance company first decided that rather than allowing me to have a month's supply of pills for a single copay, I had to instead get a weekly supply, one at a time, each time for the full copay. So, instead of paying $60/month for my pills, I was now paying $240/month for the same number of pills.
2. Then, the insurance company sent me a notice that the med I was taking, which is in my medical record as the ONLY effective treatement for me, would no longer be covered ... period. I could continue taking the pills, but I would be responsible for their full cost ($40/pill).

I appealed, and was sent a letter stating that I could continue receiving coverage for this med if I switched to mail order delivery of the pills, rather than picking them up at the local drug store. The same pills ... the same quantities. Made no sense but I filled out all the forms, and had my doctor's office fax in a new prescription.

And waited ....

And waited ....

And waited ....

I then called my doctor's office, who had indeed faxed in all the paperwork ... which the insurance company denied receiving.
The insurance company had to send ME new paperwork to fax to my doctor's office for them to re-send back to the insurance company.

And I waited ...

And I waited ...

And I waited ...

And called my doctor's office - who had sent in all the requested paperwork. And then called the insurance company, which is now denying they ever ordered me to sign up for mail order delivery ... despite the fact I have saved all the correspondence. Who is now "investigating" the situation ...
while

I wait ...

and wait ...

and wait ....

In the meantime, all I can do when I am stricken with a migraine is to take my prescription Vicodin .... which makes me unable to drive or go to work.

And this is perfectly legal for the insurance company to pull.

All I can think of to do is to fill my narcotic prescriptions (which ARE covered by the insurance company), sell them on the street, and use the money to buy the migraine meds.

[if you are still reading at this point, ]

JFC!!!! I friggin hate insurance companies!
This is why we need national health care and to get the money out of the business. Fuc*ers!

[wyndslash]

@kenny: my mom is an insurance agent xD but it's okay, people in general do have a bad image of insurance, and there are a lot of bad eggs out there

but i am unfamiliar with how the insurance companies work in other countries, though. i am so sorry you are having trouble, poohbear

[bjones6416]

I agree, exactly how this insurance business works is a mystery to me. I have perfectly good Blue Cross Blue Shield health insurance, the same plan that I've carried for years. Because I had to have this surgery right at the beginning of the year, I had to pay my deductible right up front. Then with various other fees and services that were either not paid or only partially paid, other bills have added up. I have so far paid over 900 dollars out of pocket for this operation (and associated labs and pathology)! For heaven's sake, this is considered a good insurance plan! What on earth do people do who don't have insurance at all? Because believe me, I didn't exactly have 900 dollars laying around. And without insurance, it would have been much, much more.

And yes, Pooh, I'm falling in that generic trap, too. There's not a generic for one of the prescriptions I've been put on. I'm getting it by mail order, which is the cheapest option, but still I'm paying $72 per prescription instead of the $10 it would cost me if it were generic. Based on your story, I guess I should be glad it's ONLY $72!

[kennyc]

Originally Posted by wyndslash

@kenny: my mom is an insurance agent xD but it's okay, people in general do have a bad image of insurance, and there are a lot of bad eggs out there

but i am unfamiliar with how the insurance companies work in other countries, though. i am so sorry you are having trouble, poohbear

My father was in the insurance business for years as well (after we lost the farm and before he went to work for the State) but they are still the scum of the Earth. They are primarily the ones behind the medical coverage crisis in the U.S.A. They only care about the stockholders, not the customers.

[WT Sharpe]

Originally Posted by kindlekitten

I don't PLAN on sleeping ON it, it just ends up underneath me somehow. I think it's Strider's fault

This is why I avoid bars.

[WT Sharpe]

Originally Posted by poohbear_nc

Ok - I just have to type this out to get it out of my system - and stop having an upset stomach ... migraines ... health insurance company ...

That really sucks.

(1) Have you seen a lawyer?

(2) Could you share the name of the Insurance Company so the rest of us will know to avoid it like the plague or would this open you to a libel suit?

It's really bad when Insurance companies play doctor. Do they have a license to practice medicine?

Here's hoping you get the medication you need at a reasonable price.

[kindlekitten]

Originally Posted by WT Sharpe

This is why I avoid bars.

Strider doesn't go to bars! (and I haven't been to one in.... a very long time)

[WT Sharpe]

Originally Posted by kindlekitten

Strider doesn't go to bars! (and I haven't been to one in.... a very long time)

Oh, I guess bars are safe, then.

[kindlekitten]

Originally Posted by WT Sharpe

Oh, I guess bars are safe, then.

from the likes of us at least!

[wannabee]

Sorry Pooh to hear about your long long suffering with migraine and then the insurers. Yesterday I was doing a layout for a book which had the following item about Migraine. I don't think the author would mind me posting the excerpt.

Spoiler:

Migraine Headaches
Migraine headaches – perhaps the most painful of all headaches – are caused by excessive constriction (narrowing) and then excessive dilation (expansion) of the blood vessels in your head. This explains why migraine sufferers complain of a severe pulsating or throbbing pain in the head. Migraines are surprisingly common, affecting an estimated 20 percent of all men and 25 percent to 30 percent of all women at some point in their lives. That’s a lot of people, hundreds of millions in fact, so it should help a lot of you breathe easier to know that you can count on magnesium for at least some relief.

Several different studies have determined that a magnesium deficiency can set the stage for a migraine, with one researcher saying, “The importance of magnesium in the (development) of migraine headaches is clearly established… The available evidence suggests that up to 50 percent of patients during an acute migraine attack have lowered levels of … magnesium. Infusion of magnesium results in a rapid and sustained relief of an acute migraine in such patients”.

According to other reports, magnesium can lessen the severity of a migraine by reducing the constrictions and spasms in the arteries that cause them in the first place. This improves and stabilizes the circulation of blood to the head area, including the brain.

In a double-blind study of 81 people with a history of recurrent migraines, some of the patients were given oral magnesium daily while the others received a placebo. By the ninth week, nearly 42 percent of the magnesium group reported a reduction in the frequency of their attacks, as opposed to only 15.8 percent of patients in the placebo group. But again, to be perfectly fair, I have seen results from a similar study that found magnesium, when compared to a placebo, provided no benefits in reducing the frequency of migraines.

My personal experience, along with the experiences of many of my colleagues, convinces me that this latter study was possibly flawed in some way, though I admit to having no hard evidence to support this belief. What I can and do support, however, is the opinion of the researcher who stated, “Because of an excellent safety profile and low cost, and despite the lack of definitive studies, we feel that a trial of oral magnesium supplementation can be recommended to a majority of migraine sufferers.”

I have seen many of my patients reduce the frequency and severity of many types of headaches by taking 400 mg daily of elemental magnesium. This includes tension headaches, cluster headaches and migraines.

If the migraine headaches are usually associated with nausea and vomiting, it is also important to improve the function of the liver. This can be done by increasing the amount of raw salad vegetables and raw juices in the diet and by taking a good liver tonic – see www.liverdoctor.com

Fish oil supplements can also help to reduce the inflammatory component of headaches – take two capsules of 1000 mg each, twice daily just before food. The liquid form of fish oil is much more effective and doses vary from 1 teaspoon to 1 tablespoon twice daily, just before food.

All migraine sufferers should ensure a good intake of water with the aim of drinking two liters (2 quarts) daily. This will improve the circulation of blood to the brain. Dehydration will increase the frequency and severity of headaches.

Testimonial
Dear Dr Cabot:
I am writing to tell you about the great relief I have obtained from taking magnesium tablets. Since the age of 24, I have been suffering from severe migraines that would put me to bed for at least a day. They would often start with flashing lights and nausea and just a dull ache on one side of my head. Then the pain would get worse and turn into a pulsating throbbing pain all over my head. I could not move or stand the light. Sometimes these frightening headaches would awaken me in the early hours of the morning and I would be scared I was going to have a stroke!

I have tried many different drugs over the years but they had side effects and only relieved the pain for a few hours. I nearly became addicted to pain killing injections. Then I read about the beneficial effects that magnesium could have on migraines and I thought to myself – no, it’s too simple, how could a natural substance help such severe pain?

However I was desperate; I thought, well I have nothing to lose. I started taking two Magnesium Complete tablets twice daily and found that gradually my headaches became less frequent, and when I got one, it was not as bad. I have not had a migraine for five months now and I can’t believe my luck!

My life has changed in such a great way and I no longer worry about having to cancel things and miss out on the things I love to do. I would also like to thank you for your book on raw juicing, as I am sure that the juice recipes I have been using have also helped to prevent the headaches. I no longer feel nauseated or have to live on painkillers and I think that something must have helped my liver – perhaps the magnesium or perhaps the raw juices.

Julia Mac Donald
Brisbane, Queensland

[maianhvk]

gee I can die for a donut now

[desertblues]

Originally Posted by poohbear_nc

................
As many of you know, I suffer from migraines. ......... I finally found the one perfect medication for me - it knocks out an oncoming migraine in 20 minutes with tolerable side effects. For me - nirvana (of sorts).

Well, last year one of the hundreds of currently available migration medications became available in a (cheaper) generic form. My health insurance company insisted I switch to it or else they wouldn't cover migraine med costs anymore. So I switched to it (I had tried it in the past - it didn't work) - and again proved it didn't work, and had my doctor file a medical exemption form with the insurance company, and, after several months of agony, got to take my proper med again.

Well, this year,
1. The insurance company first decided that rather than allowing me to have a month's supply of pills for a single copay, I had to instead get a weekly supply, one at a time, each time for the full copay. So, instead of paying $60/month for my pills, I was now paying $240/month for the same number of pills.
2. Then, the insurance company sent me a notice that the med I was taking, which is in my medical record as the ONLY effective treatement for me, would no longer be covered ... period. I could continue taking the pills, but I would be responsible for their full cost ($40/pill). .......................
And I waited ...

And called my doctor's office - who had sent in all the requested paperwork. And then called the insurance company, which is now denying they ever ordered me to sign up for mail order delivery ... despite the fact I have saved all the correspondence. Who is now "investigating" the situation ...
while

I wait ... ..............

In the meantime, all I can do when I am stricken with a migraine is to take my prescription Vicodin .... which makes me unable to drive or go to work.
And this is perfectly legal for the insurance company to pull.
All I can think of to do is to fill my narcotic prescriptions (which ARE covered by the insurance company), sell them on the street, and use the money to buy the migraine meds. .......

That is an awful situation. And that happens in our country as well.
Although there's the same substance in a generic tablet, it is possible that it doesn't work as well as the original, That has to do with the added substances in it, or the way it is processed.
Patients that have organized themselves in some kind of association, sometimes manage to get ' their' medication back. It's difficult, but not impossible.

We have an excellent health system, but we pay a lot of taxes.(50 % in our case)
The insurance companies have a lot of power in health care, but their power is restricted by the State. By law the insurance companies must offer basic healthcare (no frills) for all (they cannot refuse the basic care for a client) for about 100 euro's a month. Everyone in this country is insured for the basic costs, no matter what.

Our family (3 persons) pays 340 euro's per month; all costs covered, except some dental work and 'luxury' things like cosmetic surgery and so on (just for fun-things I mean).

These last few years, some people with complicated or chronic diseases get their own budget from the insurance; they can spend it on the care they want for themselves. It's a choice they make, with our without consulting their physician.

Some treatments are restricted, for example physical therapy to 12 treatments, I think. After the 12 one has to pay something (not the full amount though, if a doctor perscribes these treatments.)
And we have a so called ' own risk'; that is about 160 euro's a year and after that 160 euro all is paid. One pays that amount only once in a year.

Pooh; I find it very unjust what they are doing to you and I do hope you can work something out. Hang on!

[pdurrant]

Originally Posted by bjones6416

I'm getting it by mail order, which is the cheapest option, but still I'm paying $72 per prescription instead of the $10 it would cost me if it were generic. Based on your story, I guess I should be glad it's ONLY $72!

Good grief. I knew there were horror stories about the US system, but this day-to-day stuff almost seems worse.

In the UK, the cost of an individual prescription is at most £7.40. This covers all the medicines on one prescription.

If you have a chronic condition and need regular re-supply of medicines, such that you might need a lot of prescriptions, you can limit the amount you need to pay by buying a 3-month (£29.10) or annual (£104) pre-payment certificate.

Children and pensioners (60+) get free prescriptions.

http://www.nhs.uk/nhsengland/Healthc...tioncosts.aspx

[beppe]

@ poohbear_nc
Hang on man. I hope that you keep using what is good for you. The rest is just money, but quality of life is more important.

They are really terrible.