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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by Racer on January 16, 2008, at 15:41:37
Our insurance just changed. My husband's company just changed carriers, so the only difference is the carrier -- no new job, no new information, just a new carrier.
My husband just got back from picking up a prescription for me for something called Limbrel. It's another of those "medical food" products -- prescription, of course. Turns out, the new carrier won't cover it. Period. I called the doctor, whose office informed me that they don't dispute insurance coverage on this sort of thing. Just S-O-L, which irritates me, since the Limbrel was helping me.
The alternative medications carry a much more critical list of side effects -- the third one listed in the insert was "death," so they're not all that attractive as alternatives. Now I'm stuck, where I can pay out of pocket -- which is pretty much last resort, since it's so damned expensive -- or I can take a much more perilous medication.
Or, of course, I could just lie there in truly outrageous pain. That's an option, too. I could lie on the sofa in pain until my joint gets so bad they have to replace it. Apparently the insurance carrier will pay for that.
Grrr!
Posted by MidnightBlue on January 16, 2008, at 16:34:09
In reply to Vent about insurance woes..., posted by Racer on January 16, 2008, at 15:41:37
Racer,
Can I join you on the couch? Third insurance company in three years and no change of hubby's job either. I get tired of trying to re-invent the wheel.
Joints in hand/wrist are killing me. Waiting to get into see hand surgeon. Sigh....
MB
Never heard of Limbrel. Because of GERD all NSAIDs are out of the question.
Posted by Cecilia on January 21, 2008, at 2:07:53
In reply to Vent about insurance woes..., posted by Racer on January 16, 2008, at 15:41:37
Never heard of Limbrel either and I have bad osteoarthritis, told the only solution is a knee replacement. Too afraid, since they made my knee much worse with a simple arthroscopy. I know my HMO would laugh at the very idea of a medical food, never cover it in a million years. How much does it cost out of pocket and does it help? I know it's not going to work any miracles, but any little bit helps. Cecilia
Posted by Racer on January 22, 2008, at 1:57:42
In reply to Re: Vent about insurance woes..., posted by Cecilia on January 21, 2008, at 2:07:53
Limbrel does help -- within a couple of hours after taking it, my pain was much better. (That's when I ran out for a few days.) It's about $90 for a 30 day supply, so I won't be staying on it if the insurance doesn't cover it.
As far as I'm concerned, this [emulates a Hoover], because the alternatives have made me very sick, and have a nice, scary list of side effects. So, what about this nice medical food? Not covered...
Ask me if I have the oomph in me to appeal to the insurance company? Oh, yeah -- you don't need to ask, because you already know I'm depressed and barely functioning...
Posted by Cecilia on January 22, 2008, at 5:04:57
In reply to Re: Vent about insurance woes... » Cecilia, posted by Racer on January 22, 2008, at 1:57:42
Interesting, if this stuff actually works I'm amazed it hasn't been advertised constantly on TV. It did say in the website that it's best for mild to moderate OA, obviously I have severe if they're offering a knee replacement. Needless to say the knee replacement would cost them a lot more than a "medical food", but it's nor even listed in my HMO's formulary. I might ask my doctor for a month's prescription (self-pay) to see if it works, though I'm afraid she'll just laugh. Maybe I'll ask in Alternative if there's anything similar OTC. Cecilia
Posted by Racer on January 22, 2008, at 9:51:45
In reply to Re: Vent about insurance woes... » Racer, posted by Cecilia on January 22, 2008, at 5:04:57
In my case, it's not technically OA that's being treated. Some sort of injury started some inflammation, which is eroding the bone in my hip. There's a hole in the bone, and another hole in the soft tissue, where the fluid accumulated. The Limbrel is supposed to help reduce the inflammation, which should reduce the rate of the bone erosion.
But I also have OA, as well...
Posted by Phillipa on January 22, 2008, at 12:36:10
In reply to Re: Vent about insurance woes... » Cecilia, posted by Racer on January 22, 2008, at 9:51:45
Gotta google limbral as on the deplin so far nothing.And I'm taking as prescribed. I've got the OA too plus osterporosis one pill is $85 a month and no insurance won' t pay it so not an option. More ca and mg I guess. Wonder what will happen with these medical foods? Phillipa
Posted by Phillipa on January 22, 2008, at 12:43:24
In reply to Re: Vent about insurance woes... » Racer, posted by Phillipa on January 22, 2008, at 12:36:10
Oh does sound like the pharmacitcal companies are taking or trying to only have supplements prescription. Add that to deplin any other ones yet? Phillipa
Posted by stargazer2 on January 31, 2008, at 16:39:32
In reply to Re: Vent about insurance woes... » Racer, posted by MidnightBlue on January 16, 2008, at 16:34:09
The worse is not having a hubbie that has insurance (he's in sales) while being out on disability, going on year 2 now but looking for work right now.
You are always one step away from having no insurance so enjoy it while you have it. So many either have no insurance with a job or can't work, you know that scenerio.
Here in CT, children qualify for insurance no matter what their parent's income, but the older folks like me have nothing like this...I guess we're considered dispensible if we don't work.
This is the first time in my life that I couldn't work, I can go on Medicare if I remain disabled but that program is a mess and I don't want to remain disabled if I can work which will prove it self in time. I want to work but I am not sure I can keep from relapsing again, which happens every time I try to, perhaps not right away but usually at some point depending on my level of stress. It is so unpredictable but should I give up trying, I haven't yet,although I never was disabled before either.
Stargazer
Posted by Phillipa on January 31, 2008, at 20:10:36
In reply to Worse than woes is no insurance woes, posted by stargazer2 on January 31, 2008, at 16:39:32
Stargazer you know you can work a certain amount of hours on disability and full time for a certain amount of time to see if you can do it. I'd apply it will take probably two tries and the maybe a lawyer appeal you're set there. And test the parttime waters or full time I think is a year. Love Phillipa
Posted by MidnightBlue on January 31, 2008, at 23:08:00
In reply to Worse than woes is no insurance woes, posted by stargazer2 on January 31, 2008, at 16:39:32
I have had very expensive COBRA insurance (this was over 10 years ago) that was paid for by a charity group because the costs of my meds was more than the $700 a month payment. I have gone longer than a year with no insurance or medical care at all.
I am now assured of having insurance for the rest of my life unless there are radical changes. I realize that is a huge blessing. I am very grateful. I still have large co-payments and all sorts of hoops to jump through to be covered.
MidnightBlue
Posted by stargazer2 on January 31, 2008, at 23:09:18
In reply to Re: Worse than woes is no insurance woes » stargazer2, posted by Phillipa on January 31, 2008, at 20:10:36
A lawyer appeal for what? I don't understand what you are saying about part time and full time. My concern is getting paid health insurance with a job. That is as important as the $$ of course since I am unable to get insurance with my history. Can you believe such discrimination against anyone who has had health problems,no wonder so many stay on disability since a job with health benefits is not always guaranteed.
Anyone who tries to go back to work can always relapse and lose a job, that is very common, it's the nature of chronic depression. Any low stress job is unlikely to have benefits either ot if part time.
I have such fears about working consistently IF someone hires me.
Stargazer
Posted by Phillipa on January 31, 2008, at 23:35:01
In reply to Re: Worse than woes is no insurance woes, posted by stargazer2 on January 31, 2008, at 23:09:18
You can file for medicaire and still work part-time or full time without their benefits for I think a year before you would have to give up medicaire. I've been told that a lot of people apply two times for medicaire are turned down and then they appeal with a lawyer and that is usually when they are awarded medicaire. I was lucky got it the first time have no idea what the doc filled in but I did have the active lymes disease at the time and psych issues. I still have my license to work. But in I think July you need more schooling as I've been out of work for ll years now. Too old for school. But the medicaire system is very hard from what I've read to get into now. I do not get good med coverage but pretty good any generic ad is free. That's what I meant by appeal if turned down. Love Phillipa ps back problems, could never meet the requirements for the job the lifting and only a diploma so no desk job.
Posted by ClearSkies on February 1, 2008, at 11:08:58
In reply to Worse than woes is no insurance woes, posted by stargazer2 on January 31, 2008, at 16:39:32
Yes, we just got denied (yesterday) for the new insurance policy we applied for - six weeks after we'd done so. No calls, no inkling that this was coming. Not even catastrophic coverage, now.
I guess that means I'm heading to Target, and not to go shopping. I'm crushed. Husband wants to move to Canada, immediately. I say, bring on the butter tarts and start playing the Maple Leaf Rag!
CS
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