The what's bothering you RIGHT NOW thread Part V

[LeighWolf]

Originally Posted by sarahsweets

I meant to ask you- what was the reason because the same thing happened to me and I literally just got home with them. I won my appeal finally and the insurance has to cover three pills a day while I pay for the fourth but up until I found out last week I was paying over 269$ a month just for the adderall xr and I ran into a financial hardspot and couldnt cover them. They are..ready for this? Reimbursing me for the last six months payments and I have to file claims for the few months before but it will be so helpful!

Gonna jump in without knowing all the fact, as usual...

There have been a lot of medication shortages lately. One in particular I am really mad about. I don't know how big the scope is, but I have been forced to switch people from their med that fell in a black hole to something else. With one med, it has not been going well! Insurers are also sending "Oh, we don't pay for X. Here's a list of meds we do cover: 1, 2, 3. Um...wrong drug class, insurance company. Care to explain why X, which has been in use and cheap FOREVER now has to be replaced by something that can't replace it?! And then there's the limitations. Drug Y is three times daily. And you want it limited to 30 tabs. Gotcha. Better to pay for a hospitalization that 60 more pills per month?

Pretty lucky you got your med AND were reimbursed. Even luckier to win an appeal. I won't go into appeal stories. I only have two anyway, but "appeal" just means "Sure, go ahead and call and we'll play-act a hearing before we tell you no".

And that's my [i]bugaboo[i] this evening

[LeighWolf]

Originally Posted by psychopathetic

I

have a hard time doing things when I'm medicated...but dang, it just makes things so much worse without the meds.

...but I just couldn't get there.

I'm such a slug when I'm off my meds.

It's like my whole life is stuck in a pile of mud...and my meds help clear up some of it.

I still have a really hard time getting things done...but not nearly as much as unmediated.

And I didn't really sleep much last night,

I made a bit of a mess for myself by getting pretty upset and saying some things.

I had no words or ways to try and make sense of it for them, so I just kept getting more and more frustrated.

just tired and...I don't know. I'm having quite a lot of anger issues.

Thank you. Now I don't have to try to think up a way to say it. This is one of the reasons I like this forum. It seems like some other places people just experience this absolute blossoming on meds. With no residual symptoms. I just figured I'm either actually just lazy and brain damaged like I always thought, or something. It could be wrong med, true. But on it my emotions are in check, papers don't pile up on my desk, I don't leave my phone or laptop or cigarettes at home, I can return those phone calls, I don't ask people the same things several times, I somehow have the gumption to pay bills, I sleep well and don't awaken because my dog so much as rolled over, and my mom (who doesn't believe in ADHD) tells me I am more "alert".

Sorry you had a hard week. Think about it, though, you've gotten through plenty of times without meds. Just how would someone who didn't need meds like to feel like an amnestic, thin-skinned zombie on crack walking through molasses in the fog?

[LeighWolf]

Originally Posted by midnightstar

I feel guilty again now ........... the vet said not to give Ebony her breakfast when I took her in on her last day so they could run tests and get accurate results, I can't shake the thought now that Ebony passed away on a empty stomach

Would the vet of given her something to eat after they'd done all the tests? Making allowances for her sensitive stomach?

DON'T!! Your brain will mull that over and over until you ache with a suffering she likely didn't even experience! While they do feel both physical and emotional pain, they don't experience it in the way we imagine. We can only really know how human perceptions influence pain experience. And different cats (like different people) have differing pain tolerance. When a body is shutting down, or focusing on the mere act of breathing, hunger isn't even usually there. Did the vet feed her? Probably not is my guess. But I would bet that he or she held or stroked precious Ebony. And that is most likely what she needed. -sending you a computerized hug and understanding gaze (tearful gaze. I get your clear-eyed and unchained understanding of the suffering).

[Greyhound1]

Originally Posted by Andi

I'm shocked that as a patient I've lost a lot of control over my well being.

Sadly, our Dr’s and all of us have lost most control of our well being to our health insurers. Now, our well being care always comes second to corporate profits. It’s so messed up.

[Greyhound1]

Originally Posted by sarahsweets

I meant to ask you- what was the reason because the same thing happened to me and I literally just got home with them. I won my appeal finally and the insurance has to cover three pills a day while I pay for the fourth but up until I found out last week I was paying over 269$ a month just for the adderall xr and I ran into a financial hardspot and couldnt cover them. They are..ready for this? Reimbursing me for the last six months payments and I have to file claims for the few months before but it will be so helpful!

Glad you won your appeal. They were ripping you off and should reimburse you! It’s $100 less for 4 pills a day and that’s without any insurance.

GoodRx
Prices and coupons for 120 capsules of amphetamine salt combo XR 30mg
Publix
$171.09
with free coupon
GET FREE COUPON

[Rebelyell]

NJ doesn't have a publix here but I'm glad to see sweets won her case n she's getting money back.

[Greyhound1]

Originally Posted by Rebelyell

NJ doesn't have a publix here but I'm glad to see sweets won her case n she's getting money back.

GoodRx works where ever you live. It’s not affiliated with Publix at all. It just happened to have the best price on that med. around here. It gives you a list of the best prices in your area.

When I didn’t have insurance it was a life saver. With GoodRx my Adderall IR was $32 mos. Without GoodRx it was $140 a mos.

[psychopathetic]

Mood swings can go eat some peanuts and choke on their shells!

[psychopathetic]

Originally Posted by sarahsweets

I meant to ask you- what was the reason because the same thing happened to me and I literally just got home with them. I won my appeal finally and the insurance has to cover three pills a day while I pay for the fourth but up until I found out last week I was paying over 269$ a month just for the adderall xr and I ran into a financial hardspot and couldnt cover them. They are..ready for this? Reimbursing me for the last six months payments and I have to file claims for the few months before but it will be so helpful!

Omg...haha that is so great!! You so deserve any breaks life can send your way...this is awesome news!
Yay you!!

i ran out because I decided that fast food was more important than my meds.
I was down to $.04 in my checking account for the last week of the month haha xP. I just didn't have the money to pick them up...even though I have a very small co-pay.

Then when I finally did have the money, they needed to fax my pill lady who only works a couple of days a week (she retired but got sick of spending all her time with her husband ...so now she's working a bit again).

What I should've done is ordered in the prescription before I ran out, so that they'd of been at the pharmacy ready for me to pick up just as soon as I hd the money for them.

(((((((Sweets)))))))

I'm so happy for you!

[psychopathetic]

Originally Posted by LeighWolf

Thank you. Now I don't have to try to think up a way to say it. This is one of the reasons I like this forum. It seems like some other places people just experience this absolute blossoming on meds. With no residual symptoms. I just figured I'm either actually just lazy and brain damaged like I always thought, or something. It could be wrong med, true. But on it my emotions are in check, papers don't pile up on my desk, I don't leave my phone or laptop or cigarettes at home, I can return those phone calls, I don't ask people the same things several times, I somehow have the gumption to pay bills, I sleep well and don't awaken because my dog so much as rolled over, and my mom (who doesn't believe in ADHD) tells me I am more "alert".

Sorry you had a hard week. Think about it, though, you've gotten through plenty of times without meds. Just how would someone who didn't need meds like to feel like an amnestic, thin-skinned zombie on crack walking through molasses in the fog?

(((((((Leigh-Leighs)))))))

Yeah, this forum has been amazing for me because...dang, there's other people out there like me!
I legitimately believed that I was never going to find anyone I could ever relate with before I knew what was going on (that I had ADD).
I couldn't believe it when I was new here...I'd read post after post of people describing pretty much the exact things I've gone through!

It feels damn good to know I'm not alone...that I'm not just a f* up.

...

Originally Posted by LeighWolf

And that's my [i]bugaboo[i] this evening

[Rebelyell]

This freaking state sucks they wanna add a rain tax.can someone tell me a state that doesn't tax ya to death..I'm trying to make it and am going freaking backwards here.who the bleep goes to work to go backwards?

[tudorose]

Originally Posted by Rebelyell

This freaking state sucks they wanna add a rain tax.can someone tell me a state that doesn't tax ya to death..I'm trying to make it and am going freaking backwards here.who the bleep goes to work to go backwards?

Delaware (if what I've been told is correct)

Rain tax WTF??

[Emre22]

Originally Posted by Rebelyell

This freaking state sucks they wanna add a rain tax.can someone tell me a state that doesn't tax ya to death..I'm trying to make it and am going freaking backwards here.who the bleep goes to work to go backwards?

Rain tax ?

[finallyfound10]

Originally Posted by Rebelyell

This freaking state sucks they wanna add a rain tax.can someone tell me a state that doesn't tax ya to death..I'm trying to make it and am going freaking backwards here.who the bleep goes to work to go backwards?

What is a rain tax? I'm right next door in PA, so we will probably be getting it next!! Texas has low taxes and many people are moving there.

[sarahsweets]

The only reason I won my appeal was because I went into my husband's human resources department and laid it all out for them. It started in July when the three a day I was on was no longer covered anymore. I had been trying to get 4 covered because I was on three a day of xr and 1 of ir and wanted all xr-plus I had a vacation override so I think internally I triggered some kind of review. Its funny that these companies act like their review and appeal process is even helpful or possible. Of course they dont want to pay so they say no. I started with the patient advocacy that his employer offers to advocate on the behalf of the patient. 2 months of calls, lost paperwork, poor communication in the insurance depart. The advocate gets on the phone and is the nasty one. So after all that I was left with my doctor needing to have
"peer reviewed cited scientific evidence " for a final appeal. That is when I snapped. Went into HR and laid it out with records of all I had done thus far. Told them my theory based on the fact that it was a controlled substance and asked them why an insurance company is allowed to make medical decisions in place of my doctor when previously they must have had evidence that I did indeed need at least three a day and all of a sudden they determined I did not. All this time I was told I had to pay for it in order to demonstrate a justifiable need- meaning if I need it this bad I would even pay for it. I saved all my receipts. I was assigned an individual from the insurance company that actually had a phone number I could call but I stayed up HR's butt about it. All of a sudden last week I found out it would be covered and they called the pharmacy and were able to re-process about 6 claims. I need to go back into my receipts and find out if there are any unleft that I could get processed. Again- since July this has been a thing. I encourage anyone who has a halfway decent HR department to try their luck with them should you fail because over all they respond to you directly and are more affected by your personal story and evidence.

Originally Posted by LeighWolf

Gonna jump in without knowing all the fact, as usual...

There have been a lot of medication shortages lately. One in particular I am really mad about. I don't know how big the scope is, but I have been forced to switch people from their med that fell in a black hole to something else. With one med, it has not been going well! Insurers are also sending "Oh, we don't pay for X. Here's a list of meds we do cover: 1, 2, 3. Um...wrong drug class, insurance company. Care to explain why X, which has been in use and cheap FOREVER now has to be replaced by something that can't replace it?! And then there's the limitations. Drug Y is three times daily. And you want it limited to 30 tabs. Gotcha. Better to pay for a hospitalization that 60 more pills per month?

Pretty lucky you got your med AND were reimbursed. Even luckier to win an appeal. I won't go into appeal stories. I only have two anyway, but "appeal" just means "Sure, go ahead and call and we'll play-act a hearing before we tell you no".

And that's my [i]bugaboo[i] this evening