How do you guys deal?

Node

New member
I recently returned from Walgreens empty handed because my card got declined. Thankfully this time I will be able to return tomorrow and get the pills I need.

How do you guys deal with the extreme cost of medicine? Some corporation is profiteering off of my life and I have trouble dealing with this. I have pretty much run out of drugs to help me escape that don't negatively effect my health.

I leave walgreens once a month wishing I could murder the people responsible for charging so much for my medicine. How do you guys escape this?
 

ej0820

New member
I wish I had more input or advice to offer you. Honestly, I cut corners when I can't afford meds. I skip days just to make them last longer...or go without them completely. It's not something I'm proud of, but if that's how I can afford them, then what's the difference whether I skip some to last me, or diligently do them only to not be able to afford a refill right away?

And what's more is, as soon as I got on disability with medicare and all that, my out of pocket costs skyrocketed! Being on disability has made my disability so much more expensive, it's sickening (literally, ha).

Have you tried a different pharmacy (walmart, grocery store, etc.) or getting generic drugs? I know not everything we take is offered in generic form, especially things like enzymes or diabetic test strips, but a lot of abx are these days. Like I said, I wish I had something more productive to offer, but I'm right there with you. <img src="i/expressions/face-icon-small-sad.gif" border="0">

Good luck to you.
 

LouLou

New member
Have you taken the time to apply for patient assistance programs through each of the drug company's?

I understand the cost is frustrating but it's a miracle we have these drugs and the only reason we do is because of American pharma's innovation and push to be a business success. Just to give you an idea, my husband works in pharma as a PhD organic chemist. He went to 13 years of school post high school and works each day doing dangerous reactions with chemicals that WILL SHORTEN HIS LIFE. He will be forever very prone to cancer. He is in lead development which means he's responsible for finding compounds that could lead to being a medicinal drug. In the last 15 years the American R&D group has not been responsible for a new drug. Can you imagine? The whole company is riding on innovation from other plants in other countries. When they finally do come out with a new drug the cost is tremendous to cover the costs of what it took to get there. And if they don't prove themselves soon they risk being shut down. This is a very good example of why America needs to overhaul their schools. But I won't get into that because that's not what this post is about.

Do chk out the pharma's patient assistance programs. Let me know if you need help and I'll dig up the website addresses for you.
 

Node

New member
Thanks for the replies. I will check out the patient assistance programs I really had no idea they gave a damn about their patients.
 

JustDucky

New member
When I was first put on TOBI, I received help from their assistance program as my insurance did not cover much of it at the time (pre medicare). If you are on that drug, here's the link for the assistance program: http://www.tobitime.com/info/tools/patientassistance.jsp

As Lou lou pointed out, most companies have some sort of discount, help, co pay assist etc out there especially if you don't make much money.
I do hear you as far as paying for meds go....brand names are a nightmare once you hit that doughnut hole if you have Medicare part D insurance, which for most of us, we would hit within the first few months of the year. My doctor gives me samples of brand name drugs, even insulin once this happens to me...Appeal to your doctor/social worker and they should be able to direct you to any programs, even give samples out (my doc gives me 3 months worth of Singulair along with Symbicort, insulin etc...)
Good luck, it sucks especially if you are one of the ones who make too much for state help, but still the meds are way too expensive because food and shelter become priorities.

Hugs, Jenn
 

hockeykid

New member
Sometimes I ask my doctor to obtain specific sample medications for me. I also take advantage of the $4.00 and $10.00 drug programs that places such as Target have. Luckily, my insurance does cover a good amount of the medication I need.
 

peter

New member
"And what's more is, as soon as I got on disability with medicare and all that, my out of pocket costs skyrocketed! Being on disability has made my disability so much more expensive, it's sickening (literally, ha)."

I am wondering what is meant by out-of-pocket expenses have sky-rocketed? Maybe you could elaborate for me. I was a veteran for 6 years(I had "free" active duty coverage), I am a healthcare practioner for 40years (private health insurance), and now I'm covered by Medicare. Medicare is accepted by all the specialists I see in NYC, my annual cost to participate is barely $500 compared to the recent $12-16,000 annual premiums, hassle for authorizations for 8 or more surgeries, copays, and needing to change plans to keep it "affordable" and watch how "pre-existing" played into things.

I also know the mentioned doughnut hole is now filling in thanks to a President who campaigned to get rid of the Medicare Advantage plans ripping off taxpayers for over $10 billion in subsidizing them, by allowing THAT doughnut hole to exist, and permitting them to limit coverage for certain conditions as a Medicare plan that, it seems to me, doesn't actually work as freely or as fully as the Traditional Medicare.

I may need some enlightenment here.

Thank you for posting and allowing me to chime in.
 

ej0820

New member
Before I got SSDI and Medicare, because I was eligible for SSI, I had medicaid. Medicaid covered everything I needed. Now that I have medicare and SSDI, I'm no longer able to get medicaid (they say I make too much on SSDI now). I went from paying nothing for prescriptions to having to pay 20%. I went from being able to get everything I needed for home IVs, to only getting some things covered (medicare pays for the IV medication, not the supplies). I went from being so relieved having medicaid to cover a lot of my needs to drowning in prescription and dr. visit costs (again, medicare covers only 80%-my last dr. visit cost me around $120). That's what I mean when I say that being disabled has made my disability more expensive.
 
E

entropy

Guest
If you don't mind me asking, what kind of pills were you trying to pick up?

And when you say you've run out of pills that help you escape that don't negatively affect your health, are you talking about psychological escape or escape from costs and hassle related to paying for medications out of your own pocket? There are a few different ways to interpret what you said.

As far as having to pay for medications, apply for state benefits like medicaid. I have medicaid and I don't have to pay hardly anything.

If you're looking for a psychological escape that isn't harmful to your health there aren't many options. Sure, there are a whole lot of chemicals that will provide temporary psychological escape, but not without the severe risk of dependency whether it be physiological or psychological. People with chronic conditions tend to unconsciously seek out these types of drugs and can very easily become dependent. Happened to me, happened to my sister and she paid the ultimate price for it. Of course there is legal, government-regulated pharmacological escape which come in the form of alcoholic beverages. And there are anti-depressants (SSRIs), anti-anxiety (benzodiazepines), anti-psychotic medicines that might take the edge off and give you the ability to focus on other things besides the negatives in your life (that or dumb you down to the point where you can't focus on ANYTHING). I have taken Zoloft for almost 2 years but I wish I never started. It has absolutely zero effectiveness as far as being an 'anti-depressant,' at least for me. The only affect it has on me is that when I stop taking it I go into a seriously unpleasant and intense withdrawal. Pharmaceutical ball and chain. For me, harder to kick than opiates because of the withdrawal's longevity.

Anyway, the least harmful class of drugs is probably opiates. They're metabolically benign in most people (unless you are using a non-phenanthrene or fully synthetic opiate like meperidine or fentanyl). The human body makes morphine endogenously and knows exactly what to do with it. But as benign as they are they carry a huge risk of psychological and physiological dependence. Psychological dependence persists, often for a person's entire life, even after physiological dependence goes away. Up until the late 1950s when tricyclic antidepressants were invented opiates were routinely prescribed for depression because they WORK. I think most anyone who has been in the hospital in some kind of pain and given morphine or hydromorphone will attest to the pain relieving, both psychological and physical, effects of opiates.

Sorry for a long rant about opiates... I recently broke my back and was prescribed Oxycontin and Oxy IR. It was the best few weeks I can remember. I had energy, my lungs felt better, my back didn't hurt, I wasn't depressed. Morphine was called "God's Own Medicine" for a reason.

But, hah, all that said... good luck getting a doctor to prescribe it :)
 
E

entropy

Guest
If you don't mind me asking, what kind of pills were you trying to pick up?

And when you say you've run out of pills that help you escape that don't negatively affect your health, are you talking about psychological escape or escape from costs and hassle related to paying for medications out of your own pocket? There are a few different ways to interpret what you said.

As far as having to pay for medications, apply for state benefits like medicaid. I have medicaid and I don't have to pay hardly anything.

If you're looking for a psychological escape that isn't harmful to your health there aren't many options. Sure, there are a whole lot of chemicals that will provide temporary psychological escape, but not without the severe risk of dependency whether it be physiological or psychological. People with chronic conditions tend to unconsciously seek out these types of drugs and can very easily become dependent. Happened to me, happened to my sister and she paid the ultimate price for it. Of course there is legal, government-regulated pharmacological escape which come in the form of alcoholic beverages. And there are anti-depressants (SSRIs), anti-anxiety (benzodiazepines), anti-psychotic medicines that might take the edge off and give you the ability to focus on other things besides the negatives in your life (that or dumb you down to the point where you can't focus on ANYTHING). I have taken Zoloft for almost 2 years but I wish I never started. It has absolutely zero effectiveness as far as being an 'anti-depressant,' at least for me. The only affect it has on me is that when I stop taking it I go into a seriously unpleasant and intense withdrawal. Pharmaceutical ball and chain. For me, harder to kick than opiates because of the withdrawal's longevity.

Anyway, the least harmful class of drugs is probably opiates. They're metabolically benign in most people (unless you are using a non-phenanthrene or fully synthetic opiate like meperidine or fentanyl). The human body makes morphine endogenously and knows exactly what to do with it. But as benign as they are they carry a huge risk of psychological and physiological dependence. Psychological dependence persists, often for a person's entire life, even after physiological dependence goes away. Up until the late 1950s when tricyclic antidepressants were invented opiates were routinely prescribed for depression because they WORK. I think most anyone who has been in the hospital in some kind of pain and given morphine or hydromorphone will attest to the pain relieving, both psychological and physical, effects of opiates.

Sorry for a long rant about opiates... I recently broke my back and was prescribed Oxycontin and Oxy IR. It was the best few weeks I can remember. I had energy, my lungs felt better, my back didn't hurt, I wasn't depressed. Morphine was called "God's Own Medicine" for a reason.

But, hah, all that said... good luck getting a doctor to prescribe it :)
 

alabamamom

New member
Hi! For people on Medicare, check out Extra Help. Just google it. it is for "low income" medicare recipients, but the income limits are not too bad. it will cover all meds on your medicare RX formulary for less then $10 a piece. also, if a drug is not on your formulary, you can request an exception or during open enrollment each year (jan through march?, you can change your part D (the RX part).the good thing about extra help is that unlike QMB, there is no limit on assets. Medicaid QMB is an option if your income is low enough. it covers premiums and deductables. and if your income is even lower, you may qualify for full Medicaid as well. If you qualify for even $1 of SSI, you can get medicaid. look it all up on the official websites and call your local social security office. hopes this helps <img src="i/expressions/face-icon-small-smile.gif" border="0">
 

alabamamom

New member
btw- the Extra Help covers the doughnut hole. i am a case manager, so i deal with medicare/medicaid a good bit, message me if you need help finding the info i mentoned.
 

alabamamom

New member
btw- the Extra Help covers the doughnut hole. i am a case manager, so i deal with medicare/medicaid a good bit, message me if you need help finding the info i mentoned.
 

AnnieT

New member
Like everyone else mentioned, Patient Assistance programs are what helped me obtain my medication. You should really take the time to check it out.
 

barbiesmom2000

New member
I work with my pharmacists, and my grandmother helps pay when I can't. Otherwise, great insurance is a blessing. GL with all the meds! <img src="i/expressions/face-icon-small-smile.gif" border="0">
 

Ratatosk

Administrator
Staff member
In terms of how out of pocket expenses have increased and it seems nominal, but it does add up...

For us with medications we used to pay 10% plus a $10 copay for medications until we reached $1000 out of pocket maximum then we were just responsible for a $10 copay per med. Then the copay amount increased to 20% and a $15 copay. And more recently $15 copay for up to a months supply of meds then $30 for a 32 day - 3 month amount.

Costs of drugs have increased significantly -- tobi, pulmozyme, enzymes.... vitamins have never been covered under our plan. In January, I end up spending about $550+ out of pocket for DS tobi copay -- that's for a 1 month supply and a similar amount for pulmozyme.

Insurance copays for office calls have increased.

Insurance is getting funnier about what they'll cover. The formulary/non-formulary issue. Use the meds that are on their list or come up with 50% of the costs. With suspensions it's become trickier -- they call it compounding and they refuse to cover it at all despite there not being any comparable medication.

I get a single policy paid 100% thru work, but DH has a single with dependent policy in which he has to pay 25% and insurance premiums have gone up about 10-20% each year.
 

catfishmom

New member
Along with all the assistance programs we are on, we also use the Costco pharmacy. You don't have to be a member to use the pharmacy, call them, I can't believe how much cheaper they are on prescripts than walgreens/walmart. I get "regular" meds there. As for specific CF meds, I use the CF Pharmacy, I can make payments online to them so we don't miss out on meds. They deliver to my house within 2 days of order- no charge. Hope this helps.
 
C

ck

Guest
Last week i got a call from the pharmacy that my son's Pulmozyme was no longer going to be paid for by insurance-medicare and medicaid -and that the insurance told the pharmacy it wouldn't help to have the Dr apply because they would not be paying for it period. He has been on pulmozume since it came out in the 80's. He is 26 so it is in his hands but with school and his ministerial duties he hasn't pursued it fully. What do you think about this. It seems kind of arbitrary....I'm quite upset. Thanks, claudia
 
T

tarheel

Guest
Every night I thank god my dad takes home a six figure salary. Even with good insurance the expenses are staggering. We pay a $60 charge for things like drs appointments and a chunk for stuff like plumozyme and tobi. There are still things they won't cover like proton pump inhibitors for very arbitrary reasons. For now I just hope the stupid republicans don't repeal the healthcare bill that Obama passed. Oh yeah, I went there.
But I guess here we're all one issue voters pretty much.
 
Top