Turned away from treatment today

[SnikPlosskin]

Had to get new insurance and it’s such a scam.

One prescription they will only allow half qty (15 days for a daily med)

Lost my GI of 18 years. Only two available in 250 miles and neither specialize in IBD

They picked random, unknown doctors for my wife and I instead of our PCPs.

Gave insurance cards to cancer center - nope. No treatment for you today. Have to change the doctors (2 days) get new referral (2-3 days).

Have a gig next Wednesday and feeling super rough. Hoping I can get in before then.

****ing ****s. All of them.

[Vette40th]

Insurance companies do not lose money. We taxpayers do, and patients dont get the treatment we deserve.
I hope , and will pray, something better for you happens soon..

[ZipZap]

Yep. Spent the better part of a week getting a blood thinner script filled on something they know that could kill me quick.

[KenHorse]

If you have a Kaiser in the area, consider switching. They are MUCH less hassle than any other provider I've dealt with

[IB4TL]

OP- That's bullshit! You should raise hell


Slightly off topic.....

Anyone ever use Mark Cuban's site for filling prescriptions?

[SnikPlosskin]

Originally Posted by KenHorse

If you have a Kaiser in the area, consider switching. They are MUCH less hassle than any other provider I've dealt with

Can’t change it for a year

Originally Posted by IB4TL

OP- That's bullshit! You should raise hell



Slightly off topic.....

Anyone ever use Mark Cuban's site for filling prescriptions?

Attachment 119989

No, my stuff doesn’t cost much except a very expensive ($166k annually) drug that has specialty pharmacy, handling, shelf life. Cuban no have. Regular pharmacist no have.

They ship it to me in a foam cooler with ice packs and make as difficult as possible to get.

[SnikPlosskin]

Originally Posted by ZipZap

Yep. Spent the better part of a week getting a blood thinner script filled on something they know that could kill me quick.

I see zero justifiable reason for delays like this in 2025. ****ing ****s.

[Steve_R]

Stelara?

[Frankie the Fink]

I considered switching from Blue Cross several times, wife talked me down, and I'm glad she did. I go through none of this BS. Hope it works out for you sir.

[Rodnok1]

Stupid ass insurance covers a 15k a month script for me yet balked at 500 bill once or twice. ****wads

[A/E]

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[LilRedCorvette]

Oh, don’t get me started on my hatred of the medical industry and health insurance companies

Snik, IIRC you’re on Infliximab (Remicade)? I was on that years ago, and the way I got it covered was having it dispensed/infused at a rheumatology practice. So a $10,000-per-infusion event only cost me a $30 specialist copay through BlueCross/BlueShield. See if you can try a similar work-around…if you switched to Humira, this may work for that, too…

I’m currently post-op (surgery yesterday) and STILL waiting on my anticoagulant Rx, which I’m supposed to already be taking. My doc initially prescribed Xarelto which is over $500 bc I’m allergic to Heparin, and the insurance company (Cigna) denied it. So he prescribed Enoxaparin instead…which is a derivative of Heparin! So these asshats would rather I risk another allergic reaction to save themselves money - fking brilliant! I can assure you the ER visit from the anaphylaxis will cost way more than $500…the bill last time cost them in the neighborhood of $10-20K, and me $1,000. Plus that whole pain/suffering and potentially dying thing that nobody but myself cares about.

The thing that pisses me off to no end is that outside of my autoimmune stuff/conditions that are NO fault of my own, I am healthy on paper - thin/fit/active, walk 15 miles a day, eat right, don’t drink alcohol or smoke, not diabetic, low BP, all textbook perfect bloodwork levels, on NO medications…and they balk at covering an eye drop that is medically necessary that is $250 (that lasts me several months to a year). You’ve got fatasses with NO self control who are on all sorts of meds bc of their poor choices that cost thousands more per year than anything I need…WTF?!?! 🤬

Sorry for the healthcare rant, but I’m stuck in bed posting and there is nothing better to do

[SnikPlosskin]

Originally Posted by Frankie the Fink

I considered switching from Blue Cross several times, wife talked me down, and I'm glad she did. I go through none of this BS. Hope it works out for you sir.

Had BCBS for years. We constantly had to fight with them too

Originally Posted by Steve_R

Stelara?

That’s the stuff.

Originally Posted by LilRedCorvette

Oh, don’t get me started on my hatred of the medical industry and health insurance companies

Snik, IIRC you’re on Infliximab (Remicade)? I was on that years ago, and the way I got it covered was having it dispensed/infused at a rheumatology practice. So a $10,000-per-infusion event only cost me a $30 specialist copay through BlueCross/BlueShield. See if you can try a similar work-around…if you switched to Humira, this may work for that, too…

I’m currently post-op (surgery yesterday) and STILL waiting on my anticoagulant Rx, which I’m supposed to already be taking. My doc initially prescribed Xarelto which is over $500 bc I’m allergic to Heparin, and the insurance company (Cigna) denied it. So he prescribed Enoxaparin instead…which is a derivative of Heparin! So these asshats would rather I risk another allergic reaction to save themselves money - fking brilliant! I can assure you the ER visit from the anaphylaxis will cost way more than $500…the bill last time cost them in the neighborhood of $10-20K, and me $1,000. Plus that whole pain/suffering and potentially dying thing that nobody but myself cares about.

The thing that pisses me off to no end is that outside of my autoimmune stuff/conditions that are NO fault of my own, I am healthy on paper - thin/fit/active, walk 15 miles a day, eat right, don’t drink alcohol or smoke, not diabetic, low BP, all textbook perfect bloodwork levels, on NO medications…and they balk at covering an eye drop that is medically necessary that is $250 (that lasts me several months to a year). You’ve got fatasses with NO self control who are on all sorts of meds bc of their poor choices that cost thousands more per year than anything I need…WTF?!?! 🤬

Sorry for the healthcare rant, but I’m stuck in bed posting and there is nothing better to do

I was on Remicade for a decade. I also use the mfg program so my costs are low for the drug, but without insurance, I couldn’t get it at all.

It’s not so much the cost, it’s paying for insurance that we have to fight constantly for things that are covered, nobody is accountable and we are denied access to care regularly.

Unfortunately I am limited to the ACA for poor people insurance.

[ZipZap]

Originally Posted by SnikPlosskin

Had BCBS for years. We constantly had to fight with them too



That’s the stuff.



I was on Remicade for a decade. I also use the mfg program so my costs are low for the drug, but without insurance, I couldn’t get it at all.

It’s not so much the cost, it’s paying for insurance that we have to fight constantly for things that are covered, nobody is accountable and we are denied access to care regularly.

Unfortunately I am limited to the ACA for poor people insurance.

Eliquis made me sick AF. It was hard enough zeroing in on the dosage of Lovenox/Enoxaparin that seemed to work and didn't make me pee cranberry juice. Then they change the "special" pharmacy that was required because the specific syringe size requested was "off-size". 3 weeks of new personal interviews to determine whether I can read a syringe and find my belly (Hint, #2 was easier.)

I should receive my first shipment on Monday; I've had 2 emergency short shipments while they get their shit together.

BTW, I have BC/BS as well, but they sub drugs out to Express Scripts. Otherwise, no complaints, and with RCC, I'm pretty sure that my tummy ache ER visits, much like Snik, turn into 5 day new vehicle purchases.

[SnikPlosskin]

Originally Posted by ZipZap

Eliquis made me sick AF. It was hard enough zeroing in on the dosage of Lovenox/Enoxaparin that seemed to work and didn't make me pee cranberry juice. Then they change the "special" pharmacy that was required because the specific syringe size requested was "off-size". 3 weeks of new personal interviews to determine whether I can read a syringe and find my belly (Hint, #2 was easier.)

I should receive my first shipment on Monday; I've had 2 emergency short shipments while they get their shit together.

BTW, I have BC/BS as well, but they sub drugs out to Express Scripts. Otherwise, no complaints, and with RCC, I'm pretty sure that my tummy ache ER visits, much like Snik, turn into 5 day new vehicle purchases.

I wish my issue was “tummy aches”. But I haven’t had to be hospitalized in almost two years now. I only go if it’s life or death.

I got the neighbor lady who is a nurse to swing by on Monday and give me fluids. That should get me through.

This damn disease has been in remission for a couple years but no more. It woke up again. I’ll do what I always do - go to the doc(s) and make believe I’m fine. And work. Always work.