"I should not talk so much about myself if there were any body else whom I knew as well."
-Henry David Thoreau

Tuesday, May 7, 2013

Amen

I just heard from Sasha.  Casey got his old job back and they are all set to move in and start on Monday.  Though it’s been quite a journey over the last few months, they are in an even better situation than before.  Prayers answered.  Amen.

Remember our issue with Alex’s newest medication being denied?  We paid $225 out of pocket for the first month supply.  Dr. LePichon called the manufacturer and they have been awesome enough to send us a month supply and fight insurance for us.  Despite their dispute with insurance, the medication will still not be covered.  The manufacturer is sending another free 30 day supply and an application for us to apply for free or discounted medications in the future.  I’m waiting for the UPS man to deliver this month’s supply because it has to be signed for.  Please say a prayer that our application will be approved and Alex can continue on this medication that is helping her stay comfortable. 

On a similar note, the patch that the doctor prescribed a couple of weeks ago has also been denied.  You may know it as the motion sickness patch, but it is also used for children with special conditions that have problems with drooling.  For example, lots of children with Cerebral Palsy find it very helpful.  We had talked about this a few months ago, but held off because we were starting the other medication (from the paragraph above).  When I took Alex to the pediatrician for respiratory congestion two weeks ago we talked about it again.  Our neurologist and pediatrician talked about it and prescribed it, in the hopes that less drool would mean less saliva for her to gag on and breathe in.  The prescription required a pre-authorization, which the doctor took care of… only to be denied.  It is 158 dollars a month.  That sucks since we didn’t even get to try it. 

I don’t know why TEFRA is denying so many things that Alex needs.  I wish I had an answer or knew how to make it better.  Could these be the side effects of the cuts that the government is making?  I don’t want to jump on a bandwagon that I don’t completely understand, but it sure does seem like we are getting the shaft on the healthcare changes.  First, Drew’s insurance through work changed us to a high deductible plan in 2012.  No more co-pays.  We pay for everything until (and a big IF) we meet our deductible.  If one of us got seriously ill then we MIGHT come out on the good end of the finances, but when all we need is an occasional doctor visit then we get a raw deal.  We still pay a healthy premium every month (no ‘health’ pun intended there), but cringe at the thought of a doctor bill, a test or medication that we might need because we have to pay it in full.  Then there is Alex’s TEFRA.  Again, we pay a premium for her to have that coverage, but since it officially files as Medicaid, we have to deal with the cuts in Medicaid coverage.  It sucks.  Is this the famous Obamacare?  Whatever it is, I’m not a fan.  Maybe there is someone, somewhere who is benefiting from the changes, but we aren’t. 

I finally got Drew to go to the chiropractor.  He had his evaluation last week and went back for his first adjustment yesterday.  I really really think that this is going to make a big difference in how he feels.  Not to complain again, but thanks to our lovely insurance, it is cheaper for us to pay for the chiropractor without filing insurance.  If we file with BCBS then we have to pay what they say… $75.  If we don’t file then we only pay $40 for a visit.  That’s what happens when there is no co-pay.  Regardless, I have seen a marked improvement in my own health since getting regular adjustments.  Believe me, it is cheaper (and healthier) than frustrating doctor appointments ($100+ each time) and taking medications ($$) that only mask the pain of my chronic headaches.  I’m a believer and I will continue my twice monthly adjustments.  I haven’t suffered from those dreaded headaches in many months and I feel good. 

There is no doubt that I could make an even bigger deal out of this topic, but I’m going to resist for now.  I can’t promise that I won’t have plenty more to say on this in the future.  The truth is that I have plenty more to say right now, I’m just not going to say it.  May you all have a blessed day and may your health insurance cover the health care that you require. 

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