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Thread: OT October Chit Chat

  1. #71
    Distinguished Community Member SalpalSally's Avatar
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    OMG, Jeanie, enough is enough, already.
    Love, Sally


    "The best way out is always through". Robert Frost







  2. #72
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    The ACA is not affecting the insurance we already have and will not effect our Medicare coverage. It's the people who are not doing their job. A friend of mine is having the same problem. I went to an infectious disease doc on Wednesday who is running lab tests for lyme disease. A nurse called me on Friday and said the doc wants me to come back in for some more lab work on Monday so something must be up....

    Gabriella
    Last edited by Gabriella7; 10-26-2013 at 09:51 PM.
    Progressive/Relapsing MS, Myasthenia Gravis, Spinal Stenosis, Degenerative Disc Disease, Diabetes, Hypertension, Hashimoto's Thyroiditis
    Advocate for ADA, Artist's Community for Change, ADAPT, Universal Living in Place, HopeKeepers, Complementary and Alternative Medicine

    "Life is mostly froth and bubble, two things stand like stone. Kindness in another's trouble, Courage in your own"........Adam Lindsay Gordon

  3. #73
    Distinguished Community Member Cherie's Avatar
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    Wow! Go away for a few days and everyone pops out of the woodwork. I had somehow missed the fact that Howie is back! Grateful!!!!

    Jeanie,
    We live vicariously through you! Hope the lift is fixed quickly. Do you think this is a ramification of being rammed?

    I don't know where the comment of ACA came in and took root regarding my meds but that portion of the act does not go into effect until January 1. No...it's just blue cross being their usual uninformed, unhelpful self. LDN is $45.61/month if I am listed as having insurance (even if it doesn't cover the med) and $20 dollars for a 90 day supply if I do not have insurance listed on my file.
    Now it's Rebif. Script written on October 17. I got a call on October 22 from Lifelines stating that they had just gotten the script and needed to get info to get insurance approval. I confirmed what they had then told them BCBS only uses CareMark specialty pharmacy in this area to fill these scripts. The next day I get a call from another specialty pharmacy saying that BCBS refused to fill my script. The following day I got a call from Caremark to tell me they had received the script and were applying to BCBS for approval. Finally Friday the 25, Caremark calls to say the med is approved, she starts reading the patient information flier (not into the microphone and very quickly so as to be almost unintelligable) and when I asked her why she was doing that, she said it would be in my med when it arrived but this is a way of reinforcing the various steps along the way. Not if you don't speak as if you know what you are talking about!!! Then she says "you have a $100/month copay. Is that OK?" "NO!", I replied. "I was told that I qualified for 0% copay because I was on SSDI". "OK" , says the fast reader who does not use a microphone. "Then it will take up to a week more to process this and get you your medicine."

    Meanwhile, I take the LDN at bedtime and am generally sleeping more fully and longer than I have in years (at least 4 nights out of 7). Other than that, perhaps knuckle dragging fatigue is letting up some but if I were not looking for positive signs, I would not see them.

    It feels like some of the craziness is smoothing out in my life. I think making the decision to go off the two Boards of Directors at the condos has helped even though it does not officially happen until November 9 at the annual meetings (5 meetings in the course of one day). The next day I head across the white Mountains, Green Mountains, Berkshires, and Airondacks to get to my parents to take Dad to the Oncologist that Tuesday (the 12th) while David comes back home with another Board member who lives a half hour from us. Then things will calm...a bit...while I get used to a new med regimen again.

    Oh...yesterday was Craig's birthday. He is physically continuing to fail but when he is able to get on FB he still is every bit Craig with a wonderful sense of humor and deeply rooted knowledge that he is still here for a reason but not likely for long. He loves hearing from folks and will respond even though it is now necessary to use adaptive software to communicate.

    Blessings all

  4. #74
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    Cherie, here is your message where you blamed the ACA for holding up your catheter order. Again, I don't think the ACA has anything to do with delays with your insurance company.

    Quote Originally Posted by Cherie View Post
    This quote is hidden because you are ignoring this member. Show Quote
    What a fiasco this past week has been. I saw my neuro last Thursday the 17th and he ordered a new DMT, catheters and a few labs. It is now a week later and none of the ordered stuff has been actually approved. I pay almost $1900/month in blue Cross payments and I am on SSDI. I cannot get a DMT or Catheters because of the hold up in the Affordable Care Act legislation that would have allowed me access to these things with 48 hours normally. It is now moving into the 8th day since the orders were placed and the injectable med has not been approved nor have the catheters to relieve the inability to void. 5 years ago I would have had both with in 48hours of them being ordered.


    I am so grateful there is no emergency or I would be up a creek without a paddle.
    ...I am not a doctor nor medical professional, and don't pretend to be one, here... :o

  5. #75
    Distinguished Community Member Jeanie Z's Avatar
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    :) Hi everyone. Cherie I was not one of the MSers who had improvement on LDN but I am happy to stay the same as I was when I started LDN almost 14 years ago. I hope your trip to your folks goes well. Tell Craig I said hello. I cannot get on Facebook.

    Gabriella glad to see you post, now where is Virginia? Peg and Howie checked in and I worry when someone does not post for awhile. I'm glad to see Cat back too. Gary we still want to see a photo of your new house. Ann have you and Pizza Guy set a date yet?

    Last night I rode my scooter out to the rental van after a meeting. I lowered the ramp and my scooter would not move. The hole for the key had a metal part on the outside of the handlebar housing and it apparently fell off and the inner part was loose inside the housing. A man helped me into the van and he drug the scooter up the ramp. Now I cannot go anywhere until it is fixed.

    I called my son and he said he would come at ten in the morning. I hope he can fix it. If not I may have to get a locksmith. My van may be done tomorrow and I do want enough time to go get it and to return the rental van. For now I am just putting everything in God's hands and hoping for the best.

    Cherie I get my LDN from www.thecompounder.com and 90 days worth is $105. My insurance does not cover it as it is off label use. Take care everyone. Jeanie :)
    Last edited by Jeanie Z; 10-27-2013 at 11:11 AM. Reason: typo

  6. #76
    Distinguished Community Member Cherie's Avatar
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    Cat,
    Thank you for pointing that out to me. I honestly do not remember saying that but clearly I did. I was told that insurance regulations had tightened in preparation for the affordable care act being fully enacted in January. I get frustrated like everyone and I guess that post was proof positive. In 2003 when catheters and Rebif were ordered, I had both in less than three days.

    Jeanie,
    I get my LDN from Bay View Pharmacy http://www.bayviewrx.com/ . It was that pharmacist who told me if a Medicare or blue Cross or other insurance number is on the script for LDN, they have to charge what the insurance company sets as a reimbursable cost even if it is not covered by insurance. He said the way to get the med less expensively is to have the doc write a new script with no insurance listed. Then the cost for a 90 day supply is about $20 rather than $45 for a 30 day supply. http://www.bayviewrx.com/naltrexone/ This is their web page link with a link to order form. I've known this pharmacy and pharmacist for years and really trust them.

  7. #77
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    I'm still here mostly reading posts and not feeling up to posting anything. Sleeping a lot of the day but not sleeping at night. I do go out of the house every day to get breakfast and do some shopping just to keep from being so depressed. Also, going to a griefshare group at church once a week. I don't think it is helping me at all because most of the women are more depressed than I am.

    I just hope the infectious disease doc will find something he can treat/cure as life has become so difficult both emotionally and physically that I am getting more and more depressed. Thanks to you all for being here to listen to my vents.

    Blessings,
    Gabriella
    Last edited by Gabriella7; 10-27-2013 at 08:11 PM.
    Progressive/Relapsing MS, Myasthenia Gravis, Spinal Stenosis, Degenerative Disc Disease, Diabetes, Hypertension, Hashimoto's Thyroiditis
    Advocate for ADA, Artist's Community for Change, ADAPT, Universal Living in Place, HopeKeepers, Complementary and Alternative Medicine

    "Life is mostly froth and bubble, two things stand like stone. Kindness in another's trouble, Courage in your own"........Adam Lindsay Gordon

  8. #78
    Distinguished Community Member Howie's Avatar
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    Cool

    Cherie is my friend
    we have written many poems
    not one made a rhyme
    Evolution spans the Universe.

  9. #79
    Distinguished Community Member SalpalSally's Avatar
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    Did you sneeze Howie? Haikooooooooooooooo..LOL
    Love, Sally


    "The best way out is always through". Robert Frost







  10. #80
    Distinguished Community Member SuzE-Q's Avatar
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    YAY! Glad to see Howie in fine form and humor! You breathe life and light into BT!

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