Jessa, Ben & Spurgeon Part 3

[SassyPants]

I am on a non generic cardiac med for my tachycardia and isolated systolic hypertension. My other med is generic and very cost effective.

[Yes, TOTALLY]

18 minutes ago, RabbitKM said:

My birth control is completely covered by insurance, my acid medicine too.  Antibiotics usually cost $5 or so.  However, I am on an anti-nausea pill, and insurance will only cover 15 pills a month.  I often need to take this pill more than 15 times a month, but if I want more, I would have to pay for it.  Apparently, it would cost $170 for 30.  So for that pill, I try to limit how often I take it so that the 15 will last me all month.

As an aside, its interesting which medicines are banned here vs other places.  There's a medicine that would be helpful for my condition, but it's not sold here.  My doctor literally asked me if I was planning on going to Canada or Europe, and that I should pick up the medicine while I am there.  What's super interesting is that while it isn't even sold here, but in Europe its sold with out a prescription.  My cousin, who lives in Spain, checked on the pills for me, and it's sold for $2 for 20 pills.  I was shocked.  

I go through periods of taking zofran (aka ondansetron) which is an anti-nausea medication everyday. My specialist prescribes the tablets 60 at a time whenever I ask for them, but when I was un-diagnosed and trying to get them from my GP she would only prescribe 8 at a time because apparently they are expensive. I live in NZ so it only costs me the prescription price which is about $2.50. I also take an injectable biologic that would apparently cost $30k a year if there was no public health system. I have heard horror stories of people with the same illness as me who live in the US maxing out their insurance after a year or so and having to just take steroids all the time.

[RabbitKM]

Just now, Yes, TOTALLY said:

I go through periods of taking zofran (aka ondansetron) which is an anti-nausea medication everyday. My specialist prescribes the tablets 60 at a time whenever I ask for them, but when I was un-diagnosed and trying to get them from my GP she would only prescribe 8 at a time because apparently they are expensive. I live in NZ so it only costs me the prescription price which is about $2.50. I also take an injectable biologic that would apparently cost $30k a year if there was no public health system. I have heard horror stories of people with the same illness as me who live in the US maxing out their insurance after a year or so and having to just take steroids all the time.

Yeah, zofran is the one that would cost me $170 for 30.  It doesn't matter that I have a diagnosis, or however my doctor prescribes.  The insurance will only give me 15 a month.  

[EmmieJ]

4 hours ago, caszandra said:

For the US posters, when your Doctor gives you a prescription do you pay one price for everything or do you have to pay for each drug separately?  I'm in Scotland and we get our prescriptions free regardless how many items are on it, I am always grateful I have the NHS when the topic of healthcare comes up in threads here.  I would be in a world of trouble if I lived in the US with my health problems, I take 11 different medications a day and another one that I take only when I need it.

I have health coverage through Kaiser (which I was able to get once the Affordable Care Act went into effect - before that, Kaiser would not insure me even if I could pay the more than $600/month premium just for me, due to pre-existing conditions).  I have several different prescriptions, but most of the cost is covered and I pay co-pays that range from $10-$15 for generic meds, and slightly more for my diabetes supplies.  That's for a 3-month supply, so I pay about $45 every several months.  I'm lucky to live in California, because I think the health exchange offers many more options than the health exchanges in other states.

[Yes, TOTALLY]

1 minute ago, RabbitKM said:

Yeah, zofran is the one that would cost me $170 for 30.  It doesn't matter that I have a diagnosis, or however my doctor prescribes.  The insurance will only give me 15 a month.  

That sucks so bad, feeling nauseated all the time is the worst. One thing that helps me a lot with nausea is ginger tablets. Obviously they don't work as well as zofran but they do take the edge off.

[EmmieJ]

7 minutes ago, RabbitKM said:

Yeah, zofran is the one that would cost me $170 for 30.  It doesn't matter that I have a diagnosis, or however my doctor prescribes.  The insurance will only give me 15 a month.  

This is why I want universal health care instead of a continuance of private insurance companies, because I'm so sick of insurance companies deciding they know better than our own doctors, or us.  When Sarah Palin raved on about the death panels that would supposedly arise with the passage of the ACA, I thought "we already have death panels on the payroll of every single private health insurance company!"

[RabbitKM]

25 minutes ago, Yes, TOTALLY said:

That sucks so bad, feeling nauseated all the time is the worst. One thing that helps me a lot with nausea is ginger tablets. Obviously they don't work as well as zofran but they do take the edge off.

I do have ginger candies, but honestly, when its really bad, not even zofran helps.  So I would like to be able to take it more as a preventative, but obviously with only 15 pills thats not possible.  So I just take it at the first sign of nausea to try to prevent it from getting worse.

20 minutes ago, EmmieJ said:

This is why I want universal health care instead of a continuance of private insurance companies, because I'm so sick of insurance companies deciding they know better than our own doctors, or us.  When Sarah Palin raved on about the death panels that would supposedly arise with the passage of the ACA, I thought "we already have death panels on the payroll of every single private health insurance company!"

I agree with you.

[Yes, TOTALLY]

Just now, RabbitKM said:

I do have ginger candies, but honestly, when its really bad, not even zofran helps.  So I would like to be able to take it more as a preventative, but obviously with only 15 pills thats not possible.  So I just take it at the first sign of nausea to try to prevent it from getting worse.

 

These days I take it mainly as a preventative. I only get mild nausea now but when I was very sick the only thing that worked was not eating anything and knocking back zofran as often as possible. Hopefully your condition improves soon

[RabbitKM]

3 minutes ago, Yes, TOTALLY said:

These days I take it mainly as a preventative. I only get mild nausea now but when I was very sick the only thing that worked was not eating anything and knocking back zofran as often as possible. Hopefully your condition improves soon

Aw thank you! 

[quiverofdoubt]

I'm currently on a medication that cost around 990$.  A month. and i need it for close to a year. Thank god for our insurance plan- i pay 7$ out of pocket (i'm in the US).  I know many women who NEED this medication to maintain a pregnancy or prevent life threatening clots. But not everyone has the insurance coverage i do and have to pay out of pocket for all of it. I can't imagine, it would mean needing to make a very  scary choice.   My husband is on a cheaper medication, but it costs the same, 7& a month.  Every once in a while the insurance covers the whole cost andwe pay nothing. There seems to be no rhyme or reason at the pharmacy. Most of the time it's 7$, sometimes it's 3$ and change, and other times it's free. But we pay something like 400-600 a month for our insurance plan for the family. It gets pulled from his paycheck. so we pay for that coverage for sure.

ETA: my 994$ medication is generic. I don't want to know what the name brand would cost....

[Kjaerringa]

When my second child was born, my husband's company went bankrupt. They were self insured. I also paid for family insurance through my job, but because we both were fully insured, my husband's had to pay first.....the spouse with the first birthday in the calendar year is considered the primary insurer. Between my husband and I, we paid about  800  monthly for family insurance. When DD was a few months old, she was hospitalized for a respiratory bug, and was in the ICU. Mr. Kjaerringa's insurance would not pay, because, bankruptcy proceedings.....and mine would not pay without a statement of benefits from Mr. K's....because, secondary insurance. We begged, pleaded, and went to the state insurance board, to no avail. Blue Cross would not pay a cent. So despite the fact that we had done the careful thing.....being double insured.....we had to pay the entire $25,000 bill ourselves. We went on a payment plan that darn near killed us. Lived in an apartment that was in a really, really rough neighborhood. Mr. K  worked two full time jobs, and I worked full time, too, and took care of our kiddos.  After a while, the hospital got tired of the payment plan and demanded more....and it was blood from a turnip, I can tell you. We ended up declaring bankruptcy, and it was horrendous. Humiliating.  Agonizing.  We had tried so hard to be EXTRA responsible......I was  such a mess at the hearing  that the judge  hugged me and told me that situations like ours were what bankruptcy was  for. I  still felt like scum.  It's been over 20 years now,  and outside of immediate family, nobody else knows. But the humiliation is still there. In later years, my Dad had  a pulmonary condition. While hospitalized, he responded well to a  particular  drug.  The VA  would  not cover it, and it would have cost $1800 per month for the weekly injections. Despite  his doctor's best efforts, it was denied, and the drug company would not reduce the cost enough  to make it affordable. He died a year later.  There are no guarantees the drug would  have  completely  cured him,  but  it would have given him  more time. There are many  stories like this in the US.

[Yes, TOTALLY]

^And many Americans still don't think universal healthcare is a good idea...that's crazy to me.

[season of life]

So for the next Jessa, Ben, and Spurgeon post, could we possibly include "man of a thousand backward hats" in there? Shameless plug for my own idea.

[Ramen Amen]

3 hours ago, Kjaerringa said:

When my second child was born, my husband's company went bankrupt. They were self insured. I also paid for family insurance through my job, but because we both were fully insured, my husband's had to pay first.....the spouse with the first birthday in the calendar year is considered the primary insurer. Between my husband and I, we paid about  800  monthly for family insurance. When DD was a few months old, she was hospitalized for a respiratory bug, and was in the ICU. Mr. Kjaerringa's insurance would not pay, because, bankruptcy proceedings.....and mine would not pay without a statement of benefits from Mr. K's....because, secondary insurance. We begged, pleaded, and went to the state insurance board, to no avail. Blue Cross would not pay a cent. So despite the fact that we had done the careful thing.....being double insured.....we had to pay the entire $25,000 bill ourselves. We went on a payment plan that darn near killed us. Lived in an apartment that was in a really, really rough neighborhood. Mr. K  worked two full time jobs, and I worked full time, too, and took care of our kiddos.  After a while, the hospital got tired of the payment plan and demanded more....and it was blood from a turnip, I can tell you. We ended up declaring bankruptcy, and it was horrendous. Humiliating.  Agonizing.  We had tried so hard to be EXTRA responsible......I was  such a mess at the hearing  that the judge  hugged me and told me that situations like ours were what bankruptcy was  for. I  still felt like scum.  It's been over 20 years now,  and outside of immediate family, nobody else knows. But the humiliation is still there. In later years, my Dad had  a pulmonary condition. While hospitalized, he responded well to a  particular  drug.  The VA  would  not cover it, and it would have cost $1800 per month for the weekly injections. Despite  his doctor's best efforts, it was denied, and the drug company would not reduce the cost enough  to make it affordable. He died a year later.  There are no guarantees the drug would  have  completely  cured him,  but  it would have given him  more time. There are many  stories like this in the US.

Oh my God. How utterly devastating and horrible. This is the kind of thing I have nightmares about.  

[DuggarWatch]

5 hours ago, Kjaerringa said:

When my second child was born, my husband's company went bankrupt. They were self insured. I also paid for family insurance through my job, but because we both were fully insured, my husband's had to pay first.....the spouse with the first birthday in the calendar year is considered the primary insurer. Between my husband and I, we paid about  800  monthly for family insurance. When DD was a few months old, she was hospitalized for a respiratory bug, and was in the ICU. Mr. Kjaerringa's insurance would not pay, because, bankruptcy proceedings.....and mine would not pay without a statement of benefits from Mr. K's....because, secondary insurance. We begged, pleaded, and went to the state insurance board, to no avail. Blue Cross would not pay a cent. So despite the fact that we had done the careful thing.....being double insured.....we had to pay the entire $25,000 bill ourselves. We went on a payment plan that darn near killed us. Lived in an apartment that was in a really, really rough neighborhood. Mr. K  worked two full time jobs, and I worked full time, too, and took care of our kiddos.  After a while, the hospital got tired of the payment plan and demanded more....and it was blood from a turnip, I can tell you. We ended up declaring bankruptcy, and it was horrendous. Humiliating.  Agonizing.  We had tried so hard to be EXTRA responsible......I was  such a mess at the hearing  that the judge  hugged me and told me that situations like ours were what bankruptcy was  for. I  still felt like scum.  It's been over 20 years now,  and outside of immediate family, nobody else knows. But the humiliation is still there. In later years, my Dad had  a pulmonary condition. While hospitalized, he responded well to a  particular  drug.  The VA  would  not cover it, and it would have cost $1800 per month for the weekly injections. Despite  his doctor's best efforts, it was denied, and the drug company would not reduce the cost enough  to make it affordable. He died a year later.  There are no guarantees the drug would  have  completely  cured him,  but  it would have given him  more time. There are many  stories like this in the US.

Don't be embarrassed.  Medical bills are the #1 cause of bankruptcy in the U.S. and more than two million people file for bankruptcy every year due to medical bills. 

http://www.cnbc.com/id/100840148

[caszandra]

9 hours ago, EmCatlyn said:

The same medicines are often more expensive in the US than in Canada, Latin America or Europe.  I do not know if the reason is that the expensive research costs (which indirectly benefit consumers in other countries) are being borne primarily by US consumers. But I do know that the higher prices for textbooks in the US have indirectly subsidized the cost of textbooks in Europe and other countries for years, so I would guess that the situations may be parallel.

In the UK we have the National Institute for Health and Care Excellence, they approve new drugs for use in the NHS, if a drug is deemed too expensive you can not get it.  You have got lots of medications that are we still don't have access too, one big example is medicinal cannabis, we can not use it through the NHS as it is deemed too expensive and the benefits of using it aren't great enough for the cost, I think you might be able to get it privately but only for certain conditions like MS.

@Kjaerringa, I'm so sorry that happened to you, I hope your daughter is healthy and happy now and condolences for your dad. Like @DuggarWatch, there is nothing to be embarrassed about, it's just really sad and rage inducing that this happens to people who need the care they should have a right to without fear of losing everything.

[Elvis Presby]

Prescription costs were killing us!  One son takes 2 meds that total over 500.00 per month.  The other son is on 1 med that costs about 295.00 per month.  We applied for a program through Shire and were approved to get the Shire meds at no cost to us for 1 year (these were the ones that were over 500.00 each month).  We do not qualify for the program with the other pharmaceutical company (Lily) because we have insurance.  It doesn't matter that our deductible is very very high, as long as we have insurance at all we can't get help from Lily.  Anyway, paying a little less than 300.00 a month is much better than paying 800.00 a month.

[Boogalou]

Continued here