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Old 01-11-2007, 07:59 PM   #1
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Fabrashamx HB User
Lost Medical Benefits Need 2 Vent

Hi Gang,
Well the good news is that I no longer need to worry about my administrative hearing next month to try and keep with my doctor, because I have lost all medical benefits.
Hubby and I were on the Oregon Health Plan, kind of a state enhanced medicare program. Our youngest son turned 19 and unbeknownst to us, This dropped him off and lowered what our minimum income could be to qualify.
Because December had 5 paydays for hubby instead of 4, this put us over income by $60. Because adults without minor children are not allowed to apply until the state legislature finds more money, even if hubby cuts back his hours, we will not be allowed to reapply,
Hubby has Bi-Polar (Manic Depression) and I of course as you all know have chronic pain. So now we are supposed to find a way to pay for $2,800 worth of meds each month even though that is more than we make. If hubby misses enough doses, he could become manic and even psychotic and if that happens and he is hospitalized, I would be homeless.
I borrowed the money on monday to pay for 2 of my perscriptions, $200 for my tramadol and lortab for 1 month. Hubby is out of his zoloft and tomorrow will be out of seraquel as well.
There is some good news. I looked into Walmarts $4 generic plan, and I can get his lithium and trazadone there, as well as my Tramadol, lortab, baclofen, and cholesterol med. If we both switch our antidepressants to prozac that would be covered as well.
As an established patient, I can see my doctor for around $50 a visit, I was thinking of asking her to re-xray my fusion, but what good would it do me now,I could scrape up the cash for the x-ray, but even if it shows I need surgery, I have no way to pay even a consult fee for a neurosurgeon, lol.
I am trying to get hubby into county mental health, I'm thinking they must have a phycologist practioner that will charge on a sliding scale and keep track of his meds.
The worry and stress of the past few days have really got me in a lot of pain and I hope this is considered 'on topic', even though parts of it arent strictly about PM.
I have read the sticky post about how to help pay for meds, Its awesome and was a huge help.
I have applied for about 4 different medication discount programs, although the only one I'm really worried about is hubbys seraquel, also the fact that Walmart has 60 tramadol listed on their $4 plan as a months supply, and I take 240 of them a month. Does anyone know if they will let me pay the $4 for each 60, $16, or is that number the limit you are allowed on that price plan?
I have held my marriage together for 26 years, through mental illness, poverty. and chronic pain. I have raised 2 sons in the middle of all that and they have never had a cigarette or a drink or been in any trouble and both are in college and working. I cannot believe the state cant see how stupid it is to take two stable people with serious conditions and throw me into withdrawal and pain and hubby into madness. It makes no sense to me. and all because we made an extra $60 dollars. Sorry this is so long, thanks for letting me vent, and I am so greatful you all are here, the information and support on this board is a blessing in my life.
~Fabby

 
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Old 01-12-2007, 09:07 AM   #2
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Fabrashamx HB User
Re: Lost Medical Benefits Need 2 Vent

Any comments or advice for me would be really welcome, TIA, Fabby

 
Old 01-12-2007, 09:12 AM   #3
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cpapp31 HB User
Re: Lost Medical Benefits Need 2 Vent

Hi Fabby!

To answer your question about the Walmart plan, they set a limit on the amount you can get monthly. So the tramadol will cost $4.00 for a 30 day supply. They will only let you get that set amount for that price $4.00. You can read more about it on their website.

Take care,
Cpapp

 
Old 01-12-2007, 09:13 AM   #4
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cpapp31 HB User
Re: Lost Medical Benefits Need 2 Vent

Fabby,

I am sorry I gave you the wrong quantity. It is for 60 per month.

Take care

 
Old 01-12-2007, 09:40 AM   #5
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ozzybug HB Userozzybug HB Userozzybug HB Userozzybug HB User
Re: Lost Medical Benefits Need 2 Vent

Oh Fabby! I can't believe this happened sweetie. I know saying "I'm so sorry" won't make this better, but really, I am even more than sorry this has happened and am sending thoughts of comfort and strength your way.

I do know there are several prescription programs out there for people who need them. I used to know the name of one of them, but it escapes me now. My sister looked into it because she doesn't have insurance and her daughters get ear infections and strep throat on a fairly regular basis. I'll ask her if she remembers the name, ok?

Please take care. We are all here for you. I'll keep you in my thoughts and prayers.

 
Old 01-12-2007, 09:51 AM   #6
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trowftd3 HB User
Re: Lost Medical Benefits Need 2 Vent

Fabby,
Sorry to hear of your troubles...doesn't the healthcare system in this country suck?!
I'll be crossing my fingers that this all works out for you.

My hubby is on disability and we pay for our insurance($349/month) and I'm terrified that he won't be able to go back to work. His migraine medicine is $733 every two weeks.

Isn't there any way you can file an appeal and get your insurance back?
Don't give up! And take care, ~Mush

 
Old 01-12-2007, 10:19 AM   #7
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Fabrashamx HB User
Re: Lost Medical Benefits Need 2 Vent

Thanks a lot for the kind words, Ozzy, Trow and Cpap, The support means so much to me. I just got off the phone with a really nice lady at Walmart and I can get my 240 tramadol from them for $16 a month, Instead of the $165 I paid a few days ago . great news, most of our meds are on their $4 plan and of the ones that arent, some are cheap enough not to be a concern, and others can be switched to similar meds that are covered with just a call to the doctor, hopefully.
I called my doctors office, she wasnt in, but I told her nurse what was going on, and since I am only supposed to use one pharmacy per my contract, Is it okay to switch for cost purposes. I was kind of surprised when she didnt just say 'go ahead', she said she would check with the doctor and call me back monday. Do you guys think she would say no? I dont know what I'll do if thats the case, The other med plan I talked to today was a good deal, but it was still 250$ for 3 months, much more than the walmart prices would add up to. Thanks again for the support guys, I hope you are all having as pain free a day as possible. Hugs, Fabby

 
Old 01-12-2007, 10:31 AM   #8
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ozzybug HB Userozzybug HB Userozzybug HB Userozzybug HB User
Re: Lost Medical Benefits Need 2 Vent

Hey Fabby-
I'm so glad Walmart is able to offer this program and that most of your meds are covered under it.

I'm sure your PM won't have a problem with the switch. They should totally understand as a matter of fact. I'm sure the nurse just wanted to let the doctor know. They probably just need to note your chart with the change. My PM doctor is fine with me switching as long as I notify him before doing it.

 
Old 01-12-2007, 10:42 AM   #9
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Fabrashamx HB User
Re: Lost Medical Benefits Need 2 Vent

Thanks, Ozzy, Yeah that makes sense, they need to get everything into the chart and I suppose check and see that I havent switched pharmacys 5 times in a year or something, lol.
Trow, there is no way to request a hearing, we are persona non gratis there until the state legislature votes in money for adult aid, without a minor child, we have no standing to reapply. they would have grandfathered us in, even though our son was considered of age and taken off our plan, but once our income went over, that was it, we're off with no recourse. It really galls me that our income was $60 over, too, lol I wish they wouldnt have told me that, if it was even $200 I would feel better about it, but so close and then nothing. With hubbys bi polar and my pain, you can just about imagine what even a week without meds would do to us. Hopefully the switch will go smoothly and we wont have to do without any medication, thanks again, you guys are the best!
Hugs, Fabby

 
Old 01-12-2007, 10:46 AM   #10
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cpapp31 HB User
Re: Lost Medical Benefits Need 2 Vent

Fabby that's great news, Walmart will work with you on the quantity. When I called they said it was a limited amout of meds for every 30 days.

Maybe, the person at my Walmart had his head up his you know what

Take care and let us know how it turns out with your PM, okay?

 
Old 01-12-2007, 12:05 PM   #11
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Fabrashamx HB User
Re: Lost Medical Benefits Need 2 Vent

Doctor just called me herself, she said of course I can switch pharmacys and if there is anything else she can do just call. Things are looking up!
Hugs, Fabby

 
Old 01-12-2007, 03:28 PM   #12
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Re: Lost Medical Benefits Need 2 Vent

Koyla, Thank you for post. I do not agree with the teachings of Ramdev and while I am glad to hear that yoga is helpful to you, It is not something that has worked for me. I DO practice imagery,massage, and circular breathing which was taught to me at first for use during childbirth by my saxophone playing hubby lol. Different things work for different people and again I thank you kindly for your post.
Your Friend, Fabby

 
Old 01-12-2007, 04:38 PM   #13
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RetiredDirector HB UserRetiredDirector HB User
Re: Lost Medical Benefits Need 2 Vent

Hi Fabby: I was just writing you a post and something happened and I lost it all. I hate that when it happens. I don't know too much about prescription programs, but since I use to live near [removed], I thought I would pass what I do know along to you.

Each manufacture (most of them anyway) have free drug programs if you can't afford the meds. You need to contact them and see what each one has. I think you can get almost anything from Oxycontin to Lithium.

I think I would get the manufactures names of all the prescriptions you and your husband have. Then do a search for their websites and see if they have a free program or maybe minimal charge. Also, there have been several people that have posted here saying they were getting their meds free from a certain manufacture. Do a search of this board for free medication programs or something like that and see if you can find out more how these work. Have you looked into Social Security Disability? I'm on that, and it at least gives you some income.

Good luck to a fellow Oregonian (I'm in Washington now, tho) and I hope you're able to find out something that will help you.
__________________
Director

Last edited by HBMod07; 01-14-2007 at 04:13 AM. Reason: Please do not post that much personal information

 
Old 01-12-2007, 07:25 PM   #14
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Fabrashamx HB User
Re: Lost Medical Benefits Need 2 Vent

Thanks Director!
[removed]The only med we havent dialed in yet is hubbys seroquel, the price is $587 for a months supply, so we will have to do something obviously, If the doctor doesnt know of a similar cheaper med to switch him to, I will contact the manufacturer and try and get a 'scholorship' for him.
I am a native Oregonian, was born in Eugene, But my mom is from Washington, She was born in Gig Harbor, My sister lives in Tacoma and neice is in Seattle. Love the pacific northwest, I have never wanted to live anywhere else. Thanks for the support, hope you have a good weekend.
Your Friend, Fabby

Last edited by HBMod07; 01-14-2007 at 04:14 AM. Reason: Please do not post that much personal information

 
Old 01-13-2007, 12:18 AM   #15
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blu_skies HB User
Re: Lost Medical Benefits Need 2 Vent

Hi Fabby !

I posted right after you first did last nite and my post isnt on here..Dont know what haoppend to it but to sum the rambling up, I just wished you well and really hate to read about what happened but am really happy that things already are looking up !
Prayers work wonders !!

Hey , you mentioned lortab on walmarts list...I have a friend who has no insurance and needs to participate in this !..I looked at the Walmart site and didnt see it mentioned

I used to take seroquel and there is NO WAY I would have been able to take it without insurance

Hopefully youll get a huge break on those too !!!

Great luck to you and yours !!!

 
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