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Friday, June 26, 2020
Same old, Same old
About two years ago I was told that I was not eligible to get help with my Prolia prescription because of my health insurance and Medicare's decision to not help unless I was over 65. It was the only medication that actually seemed to be helping my bones. The prior two meds only made me worse.
So I went online to numerous agencies, my PA and her nurse got involved and even Adam got into the mix to try and find a way. You see, I'm not Blythe Danner and I cannot afford $3,200 + the nurse appointment twice a year. After well over 25 hours of work and time on many, many phone calls and websites we all realized I wasn't going to get the help I was in desperate need of having.
Even though the cheap osteoporosis medication was part of the main reason I have extremely "holey" bones, that was the best anyone could do without doing absolutely NOTHING.
At the beginning of this horrible year we switched health insurance companies again, so my new PA (prior one retired) decided to start the entire process again to see if we could be successful.
A very nice woman was helping with the red tape. On Monday, I received a call telling me that the insurance company had approved the meds! Next came a call from the nurse in the rheumatologist's office telling me what to do to enroll in the program. I kept asking, "Are you sure that they've approved to help pay for it and not just approved the drug????" She assured me that my "fair share" would only be the nurse's visit of $25.
Now I'm hopeful and over the moon with the possibilities of sometime in the next 5 years being able to have the extremely painful and risky surgeries for various parts of my body to get the needed fusions and replacements!
I only had to print out the information that was sent to me, call the Prolia help/hotline and enroll.
Sigh. First came the ubiquitous time on hold. Then the woman said, "I'm so sorry but you're also on Medicare and this is only for people with commercial insurance." I pointed out that the Medicare was secondary, that my health insurer said I was approved and that everyone knew all of this for the last 3-1/2 months (yes, it took this long)!
She said, "yes you were approved to get the drug, but not for anyone to help you pay for it!"
Then came the number to help "people in your position". Really? The same one I called a couple of years ago who told me they wouldn't help a disabled person on Medicare, just those who were over 65!
I'm disgusted. I'm exhausted. Quite frankly, I have no hope of ever getting this drug. I'm guessing I'm not the only one in this same position. NO where to go and NO where to turn.
Piffle.
So I went online to numerous agencies, my PA and her nurse got involved and even Adam got into the mix to try and find a way. You see, I'm not Blythe Danner and I cannot afford $3,200 + the nurse appointment twice a year. After well over 25 hours of work and time on many, many phone calls and websites we all realized I wasn't going to get the help I was in desperate need of having.
Even though the cheap osteoporosis medication was part of the main reason I have extremely "holey" bones, that was the best anyone could do without doing absolutely NOTHING.
At the beginning of this horrible year we switched health insurance companies again, so my new PA (prior one retired) decided to start the entire process again to see if we could be successful.
A very nice woman was helping with the red tape. On Monday, I received a call telling me that the insurance company had approved the meds! Next came a call from the nurse in the rheumatologist's office telling me what to do to enroll in the program. I kept asking, "Are you sure that they've approved to help pay for it and not just approved the drug????" She assured me that my "fair share" would only be the nurse's visit of $25.
Now I'm hopeful and over the moon with the possibilities of sometime in the next 5 years being able to have the extremely painful and risky surgeries for various parts of my body to get the needed fusions and replacements!
I only had to print out the information that was sent to me, call the Prolia help/hotline and enroll.
Sigh. First came the ubiquitous time on hold. Then the woman said, "I'm so sorry but you're also on Medicare and this is only for people with commercial insurance." I pointed out that the Medicare was secondary, that my health insurer said I was approved and that everyone knew all of this for the last 3-1/2 months (yes, it took this long)!
She said, "yes you were approved to get the drug, but not for anyone to help you pay for it!"
Then came the number to help "people in your position". Really? The same one I called a couple of years ago who told me they wouldn't help a disabled person on Medicare, just those who were over 65!
I'm disgusted. I'm exhausted. Quite frankly, I have no hope of ever getting this drug. I'm guessing I'm not the only one in this same position. NO where to go and NO where to turn.
Piffle.
