Medication Bureaucracy-“ So Tired of it.” - My MSAA Community

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Medication Bureaucracy-“ So Tired of it.”

stepsforNeeC profile image
32 Replies

Hello Everybody, Before I begin I’m not having a mid life “identity crisis.” For whatever reason, my GratefulNeeC didn’t covert with my Christmas 🎄 gifts of gadgets! So StepsforNeeC is back! I have been battling with my Prescription Coverage through my husband’s job. First, Clinical Review, followed by “did I try any other medication” ? Lastly, approved Copaxone for a $4000.00 Co -Pay; why because I take the Brand instead of the generic - “ Ancillary differential “ or so they call it! Now, I’m told to have my doctor write a letter stating the generic makes me ill. Do you think someone read that Same Information in my mammoth patient notes that were emailed????? Now they’re working on it after my doctor emails the and Monday is Dr. Kings Birthday so probably further delay! Things gotta get better for us! Blessings and Peace. Need

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stepsforNeeC
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32 Replies
bxrmom profile image
bxrmom

Insurance companies are about the money and not the patients :( They know absolutely nothing about the medications, what they treat, or the people taking them. They just see $$$$ and that's all they care about.

Hope you are able to get things straightened out after the holiday.

stepsforNeeC profile image
stepsforNeeC in reply tobxrmom

Thank you my friend- me too 🙏

AquaZumbaFan profile image
AquaZumbaFan

My beloved father and father in law would have both told me insurance companies are a racquet!! 😂 sad but so true.. they were both from the great generation… Born in 1917 and 1915 respectively.

stepsforNeeC profile image
stepsforNeeC in reply toAquaZumbaFan

Yes. like my daddy ❤️

AquaZumbaFan profile image
AquaZumbaFan in reply tostepsforNeeC

❤️

Cwright170994 profile image
Cwright170994

🫂❤️ what, in the fucking hell, is the insurance trying to do?!?!?! 😤🤬 I cannot offer any advice as I live in the UK, and currently we've got the NHS (free at the point of use) unless PM Rishi Sunak changes things. I'm angry with you... furious even... because your country seems to not care WHATSOEVER about you! All I can offer is a virtual hug 🫂

stepsforNeeC profile image
stepsforNeeC in reply toCwright170994

Exactly, my friend! The whole experience triggered a migraine and I told them that!!! Welcome to our world. Blessings and Thank you. NeeC

ahrogers profile image
ahrogers

Sorry the generic doesn't work for you, that would make it easy. Have you considered a different DMT? There are so many out there now compared to when I was on Re if. Glad I got off it. My injection sites were becoming a problem.

Your doctor probably needs to do a peer to peer with the insurance company doctor. It also helps when the patient calls as well. Good luck.

stepsforNeeC profile image
stepsforNeeC in reply toahrogers

Thank you. I may consider investigating other DMT’s as well. My doc was a little skeptical due to other health issues (low blood pressure etc.) But I guess, “truth be told “ there’s Pros and Cons with everything. Pick and chose your battles right.

ahrogers profile image
ahrogers in reply tostepsforNeeC

That's for sure!

CatsandCars profile image
CatsandCars

That is awful, infuriating, and unfortunately par for the course. Insurance companies make it intentionally difficult because they want you to give up so they can keep their money. I have had to fight with insurance companies to pay for things that were supposed to be covered at the cost of anxiety and tons of I-can't-sleep at night-anger for weeks or months at a time. It SUCKS!

Sometimes you have to be a warrior and keep fighting if it's something you have to resolve. But if it's something that's going to be a repetitive, ongoing source of stress, it might be worth it to change meds. Maybe after this round of fighting, maybe see how long it stays resolved for before you have to fight again. It sounds like you're close to getting this resolved, hopefully. I am very sorry that you have to put up with this ridiculous crap. As if if having MS isn't bad enough!

MSbeGone profile image
MSbeGone

Hello, hopefully things are the same. However, when I was taking Copaxone they had a company that offered financial assistance in which my co-pay ended up being just a few dollars a month. The bad thing is, I do not remember the name, however, it was through the company of Copaxone, ask to apply for financial assistance. Hopefully this works. I wish you the best.

stepsforNeeC profile image
stepsforNeeC in reply toMSbeGone

Thank you my friend 🙏

mrsmike9 profile image
mrsmike9 in reply toMSbeGone

I'm glad to see you wrote this. I was on it a number of years ago and had the copay assistance as well. I know I never paid for any of it.

stepsforNeeC profile image
stepsforNeeC in reply tomrsmike9

We have enough to deal with and staying healthy should not be this difficult 😞 I was told last night I would have an expedited delivery and confirm Monday. 🙏 Thanks for your support. NeeC

MSbeGone profile image
MSbeGone in reply tomrsmike9

We have to help and look out for one another

stepsforNeeC profile image
stepsforNeeC in reply toMSbeGone

Yes we do my friend! 😊

Goldilockssearching profile image
Goldilockssearching

my neuro needs to send the same letter of medical necessity every year x5 years. Plus approved specialty pharmacy only carries generic so that’s a whole other approval thing. Sad part is I received an email to refill, scheduled, never notified but cancelled. Our pharmacy is out of network was the reason given. So, my records/acct showing you sent me the drug all of last year doesn’t factor in? Need to start from scratch every damn time! With everything digital now you’d think others would be able to share info & play nice. WE are the ones affected. Stress reduction, how?

Hopefully all works out for you. Mine usually does but is an unnecessary frustrating process!

falalalala profile image
falalalala

I hope it gets resolved soon.

stepsforNeeC profile image
stepsforNeeC in reply tofalalalala

Thank you! After hours on the phone it did🙏

stepsforNeeC profile image
stepsforNeeC in reply tofalalalala

It did. Thank God🙏

12345Gram profile image
12345Gram

Hi

The generic does not work for me and also I had issues with it my doc wrote a note and it was covered. Now I am on a Medicare supplement and get assistance with the copay. Not sure if you are working or on Medicare but there are assistance programs that will help with a copay depending on your financials. Wait to see what is covered if it’s still the outrageous co pay contact the pharmaceutical company and ask what programs are available

stepsforNeeC profile image
stepsforNeeC in reply to12345Gram

Thanks, praise God I did get it worked out, after hours on the phone; spoke with upper management. We shouldn’t have to go to these obstacles to stay healthy.

Linda3579 profile image
Linda3579 in reply tostepsforNeeC

NeeC, I’m so glad you got it worked out. I’m so sorry you had so much stress in getting it resolved. It’s just not right that we have to fight for the medicines we need. I was on copaxone for 5 years. I think it worked well for me. My neuro switched me to Ocrevus several years ago.

I think it’s a bit of a guessing game to know which

DMT will be best. Wishing you the best.

stepsforNeeC profile image
stepsforNeeC in reply toLinda3579

Thank you, and yes it is a guessing game with our DMT’s at times. I also take Naproxen for muscle pain and Flexeril PRN. Trying more Vegan dishes in my diet to improve my health. I saw a clip on T.V. with a Doctor who has MS started a “Ping Pong “ Recreation Center. He stated movement improved his symptoms. I wish I remembered his name. Blessings and Peace

Linda3579 profile image
Linda3579 in reply tostepsforNeeC

I think that doctor is Antonio Barbera.

stepsforNeeC profile image
stepsforNeeC in reply toLinda3579

Cool. Thanks- his story is inspirational!

CatsandCars profile image
CatsandCars in reply tostepsforNeeC

Yay! Success. Glad to hear it!

stepsforNeeC profile image
stepsforNeeC in reply toCatsandCars

❤️ Thank you 😊

Linda3579 profile image
Linda3579

Yes it is. Thank you for bringing it up.

Wishing you the best.

cljones profile image
cljones

when I was on Copaxone I was able to get assistance through the company that manufactures it. I have low income and wasn't able to afford the copay on it. So my doctor was able to hook me up with the ones that can give assistance for medication. You might try checking with your doctor about agencies that can help with copays. There is also charitable organizations that help with co-pays on different medications. The pan Foundation and patient advocate copay assistance also helps with things like that.

stepsforNeeC profile image
stepsforNeeC in reply tocljones

Thanks. Everything worked out, thank God🙏

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