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LONG35 Posts: 10,325
8/20/11 6:24 P

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You can bet your boot I'm worried about what next year, and the year after hold. Our politicians (all of them) have never had to live on a low/fixed income. They don't know what they are doing to us, nor do they particularly care. It's all a game to them, while they manipulate our lives. I'm with you Libby, I'm scared sh-----less.
Fran

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8/20/11 4:38 P

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An update to my original post on this thread.......

yes...I'm in the 'hole' and my doctor does want to work with me. I've used a certain brand of pain patch for months. He gave me some patches with the same dose of medicine.......different manufacturers. DISASTER! I had a terrible reaction=== and vowed to pay what I must, and buy what I need....no matter what the sacrifice.

I wonder what will happen to Medicare Plan D next year and the next etc. It truly scares me. Currently, the plan is to phase out the 'donut' hole little by little. Don't want to get into politics here, but there are some who would do away with Medicare entirely.....not to mention plan D.

I just take it day by day.
I really need the meds I take. How I'll afford them all going forward is an open question.

Libby emoticon

"Finish each day, and be done with it.
You have done what you could.
Some blunders and absurdities have crept in.
Forget them as soon as you can."
Emerson

Happy is the day I'm pain-free


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LONG35 Posts: 10,325
8/20/11 1:35 A

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Well, we got lucky - after many hours on the phone. We finally got a group to help with the cost, and the doctor went to a different medi that is not so expensive (after being prodded by his piers). My friend went in for a heart test today because this medi can cause heart problems and they want to head it off. She, theoretically will begin chemo next week. Time to take a deep breath.

Marianne, sometimes generic drugs won't work for the individual problem. I have been in the donut hole since last month - nothing I or my doctors can do about it. They do give me samples when they are available - but for Celebrex - they don't get samples anymore. It's to old. I tried something else, and it reminded me of why I take Celebrex - didn't help at all. Don't know what I'll do when I retire, but for now I'm OK.
Night all
Fran

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8/19/11 11:10 A

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Libby,
Hang in there and keep fighting. Look for an Ombudsman number in your doctor's office or the hospital or call the Sr. Services for the number of one. They are free help and can do wonders for us when we need help. Ask your dr. for samples and for generic drugs. Call the drug companies or ask your pharmacist which companies will help you out. Call your Congressman and tell him what is going on. It is amazing what each of these folks can do when we push all of their buttons.

Do not sell your home and do not panic. If nothing else, ask your bank and an attorney about a Reverse Mortgage where they pay you for your home and let you live there until you die or move to a nursing home. There are options but we have to fight for them.

My prayers are with each of you as I also take a lot of Rx and so does my DH, who had a stroke in 2002. It took awhile but we have finally gotten all generic Rx and enough samples to carrry us through. You can do this!! The stress eating will stop once you take a deep breath and start journaling what you can do. You are such a blessing to this team and we need you!! Hugs, Marianne

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LONG35 Posts: 10,325
7/9/11 2:02 P

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Libby, have you ever considered bio-feedback for your pain? It really does work. Your mind is a very powerful organ, and with proper training (my niece went to UCLA for training - she has several auto-immune issues) it can mitigate your pain - and all for free after the training. You really do need to look at other options before you start thinking of selling your home. Even a roommate would be a better option than that.

I absolutely agree, the whole issue of cost is so out of control the average person can't afford to be sick or needy in any way. If we all looked into natural remedies, and eliminated much of the medi's we take, the bad guys would have to make some changes - so from that standpoint, I guess we all have to take some blame. We have enabled them to take advantage of us. As it stands now, I pay out of pocket approximately $1,000 between September and December of each year because I'm not losing weight, not watching my diet, taking the lazy way out by taking pills that cost too much. I know, some people have to have the medi's to survive - most don't.

Now that I've had my rant, it's time for me to go to work.
Fran

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7/9/11 12:07 P

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Fran: You are a GREAT friend!! She's so lucky to have you.....

In general, this whole issue is CRAZY!! Just reading the postings.....I'm crying at the insanity. People are dying and the drug companies are getting richer and the insurance companies have no heart and, and, and.............

I suppose I should consider myself lucky that my costs will be under $1000 for only four months.
While I will feel this dearly..........yes I will...........it seems that many people are in far more dire straits!! And it only will get worse, I fear. Eventually, I'll have to sell my home of 22 years - that I Iove - where there are people who care about me (I live alone & have no family left in the area)
and move to a smaller, cheaper home where I'll be a stranger. At this stage of my life- it's the last thing I want to do.........

What a world!!

Libby emoticon

PS.....worst of all, I've started stress eating again. Have to STOP!!!!!

Edited by: LIBBYG7 at: 7/9/2011 (12:10)
"Finish each day, and be done with it.
You have done what you could.
Some blunders and absurdities have crept in.
Forget them as soon as you can."
Emerson

Happy is the day I'm pain-free


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KIERAE's Photo KIERAE SparkPoints: (177,652)
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7/9/11 3:58 A

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The doctor has no control over the costs of the drugs nor any influence on what is covered by the insurance/copay. All they can do is go to bat for you by filling out any paperwork required by the drug companies assistance program or IF there is a viable alternative med, they can prescribe that. This has been my reality for the last 10 years which is what brought me into the research drugs. I just finished a 5 year research study on a RA drug that has actually worked for me. The drug company has decided against open label (ie provide their research folks the drug for a couple years free which would allow the price to come down a bit). They do have assistance but again, the only way I would have to divorce my husband (ie lose income). The drug runs 3000-5000/month right now. Drug companies look to recoup for their research costs and make the most money as possible until the drug becomes available to go generic. Insurance companies find it more cost effective to pay for a joint replacement (ie average is 20-50thousand) then to pay for a drug that could cost 36-60thousand for a year. Sad but true.

Once again I will be researching costs of the various biologics that have" aged" in the last 5 years so might be financially feasible. If none, I will bide time and find another research program and roll the dice. Many americans cringe and rant over socialized type medicine but the only winners in our system is the insurance companies and moreso the drug companies.

I like living. I have sometimes been wildly, despairingly, acutely miserable, racked with sorrow, but through it all I still know quite certainly that just to be alive is a grand thing. Agatha Christie
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LONG35 Posts: 10,325
7/9/11 2:24 A

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Well, we tried all the suggested sites. My friend has a list the American Cancer Society gave her and she has touched base with all of them. None will cover the particular drug the Dr wants to give her, and he won't give her a break. Next move is finding out who the mfgr is and contacting them (Monday is a good day for that). I think the Dr needs to change the medi to one she can afford (it's chemo) or at least one she can get help with. This is nuts!
Night all
Fran

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7/9/11 1:46 A

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We don't have that cost problem for most meds in NZ, but I have seen many members in the States suggest writing or contacting the Drug Manufacturers. They evidently give out some of their meds for free in certain circumstances. Also, Dr's often have samples that they can give to help reduce costs, too! Perhaps those are angles worth looking at.

Kris

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LONG35 Posts: 10,325
7/8/11 7:50 P

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Thank you Libby. We are, as we speak, making the phone calls.
Thanks for the web page address, Vali. I will definitely check it out.
If they don't cover it - they may have suggestions. These people are living on Social Security, they certainly should be eligible for at least one of these programs. I haven't found out who the mfg is yet, but when I find out my fingers will do the dialing. We have the
American Cancer Society here, we have City of Hope here - no excuse why the lady shouldn't find some help. Maybe the Dr can change the chemo so she doesn't have to pay the co-pay? Could be a greedy Dr.? I'm still doing the legwork. Thanks again.
Fran

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7/8/11 7:35 P

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Fran, are there any patient assistance programs that your friend can get into? My MS injections are entirely paid for every month by the Chronic Disease Fund, which can be found at cdfund.org. I don't know if they cover chemo drugs or any of the drugs that any of the rest of you are using, but I think it would be worth checking them out just to see if there's any possibility of getting help from them. Also, most drug manufacturers have some kind of patient assistance program, but they aren't advertised very well. I just hate to think of all of you having to live without the meds that you need just because some stupid bureaucrats wasted all of the money that's supposed to be helping you to pay for them. emoticon

Edited by: VALI_T at: 7/8/2011 (20:00)
There was much rejoicing!


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7/8/11 6:42 P

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Fran,
That is SHAMEFUL! As a cancer survivor myself, I can't conceive that they won't pay for your friend's chemo. Can't the doctor 'float' her?? She should call the American Cancer Society (Association??) - they are very helpful on a lot of fronts.

Good luck.....

Libby emoticon

"Finish each day, and be done with it.
You have done what you could.
Some blunders and absurdities have crept in.
Forget them as soon as you can."
Emerson

Happy is the day I'm pain-free


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LONG35 Posts: 10,325
7/8/11 6:07 P

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Reminds me a girlfriend who had cancer surgery last month. The Dr wants to do chemo on her - but each visit will cost her $600. She called to find out why since she has an HMO, and found at that the drug actually costs $3,000/ea., and the insurance co will only pay $2,400. Now that really makes sense! If they will pay $2,400, why won't they pay the balance? Hmmmmm? She is looking for another way to pay for it - or she just won't have the treatments. So much for good insurance.
Fran

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7/8/11 5:53 P

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While I feel bad for all of us, it is comforting to realize I'm not alone in this dilemma!

As for generics.....I use them whenever I can. The $350 pain patches ARE generic. The brand costs $1000 A MONTH!

Canada is a decent source.......but you can't order controlled substances from there.

I guess I better plan better for next year. I'm still shaken up!!

Hang in there.......
Libby

"Finish each day, and be done with it.
You have done what you could.
Some blunders and absurdities have crept in.
Forget them as soon as you can."
Emerson

Happy is the day I'm pain-free


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LONG35 Posts: 10,325
7/8/11 5:32 P

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I suspect we have all checked into generic where possible. As for me, what I'm taking doesn't come generic, nor is there anything generic that will do the job. Has anyone looked at Canada recently?
For a while they were cheaper and buying from Canada was all the rage. What do we know about that? I suspect that they got smart and raised their prices?
Fran

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7/8/11 3:16 P

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Is it possible to use generic instead of name brands? I know some meds can be switched to generic and some can not, have you looked into it? It would save you some money.

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7/8/11 3:14 P

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I'm in it, too. My most expensive meds for for Asthma and allergies. Lat year I didn't get in until Sept. I guess I just have to live with it and do save up in advance to cover the bills.
Good luck !



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LONG35 Posts: 10,325
7/8/11 2:01 P

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Libby, lots of us are in your shoes. I run out of money by September each year, and it's my BP medi, along with a couple of arthritis medi's that are causing the problem. That's why I'm still working at 76. The only alternative that I have found is to go to an HMO (which is what I will have to do when I finally retire) - but then, sometimes they won't let you have the expensive medi's so that only moderately helps. On the other hand, you don't have to pay for your insurance, so you have more spendable income with which to pay for the pain medication. For "we the people" it's a lose, lose situation.
Fran


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7/8/11 10:58 A

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Hi all.
Some of us over 65 and on Medicare, use very expensive pain meds. I am enrolled in Medicare Part D prescription coverage.....and so far my co-pays have been modest. I never realized that the pain patches I use to control my runaway pain, are so expensive....as are some of my other non-pain meds.

So when I found out that I used up all my $ under the plan....and as of next month, I will be in the 'hole'....I inquired as to the retail costs of my prescription meds. I almost fainted!
From August until the end of the year, my out of pocket costs will be almost $800 a month!!!
I really cannot afford this........and I cannot afford to stop the pain meds. In fact, I CAN'T stop them cold turkey.

I'm not sure what to do. I plan to talk to my doctor (who should have told me the meds were so expensive....), but I have to wait over a week to see him. The pharmacy can't help... And on paper, I have too much income to qualify for any assistance from anywhere.

It's a wierd place I am finding myself in.......I never had to worry about this before. I've always had enough insurance to cover my needs. It's only this year - as the pain became unbearable - that I started using these expensive pain meds.

Anyone else ever been in this situation??? Anyone have any ideas?? As I said, on paper, I wouldn't qualify for help......But my living costs are high and there isn't enough left over to pay for these ridiculously costly meds.

Any suggestions would be so appreciated. Thanks,

Libby
emoticon

"Finish each day, and be done with it.
You have done what you could.
Some blunders and absurdities have crept in.
Forget them as soon as you can."
Emerson

Happy is the day I'm pain-free


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