Health insurance companies suck!!

[gollygee]

We so need a national health care system.

I get bad migraine headaches. My insurance company used to let me have 9 headache pills a month, which was more than enough. Now I am limited to 4 a month. A headache lasts up to 3 days, and I can take (and sometimes need) up to 2 pills a day. DO THE MATH. I usually get one to two headaches a month. I've had a cat scan - these are just typical migraine headaches, generally prompted by hormones though occasionally triggered by something else. The medicine has really made my life better.

What pisses me off is that my health insurance company is making decisions about my health that have a serious negative effect on my quality of life over money and money alone.

And I have really good insurance. This medication is very expensive (which is why they don't want me to have much) and I wouldn't be able to afford it at all without my insurance. I feel terrible for migraine sufferers who don't have good insurance and can't get any medication to help them.

[knitter4democracy]

1. Has your doctor tried fighting them?

Sometimes that works.

And yes, they all suck.

[onecent]

5. Yes, let your doctor know. My husband and I have both been prescribed

pills that the Ins. co. has denied. He had to contact them and both times they approved the meds for 1 year. (Nice of them, since they know me better than my doctor...)

It does suck

[Coyote_Bandit]

2. Consider yourself lucky

I would be out of pocket over $7500 before my insurance company paid a single penny for anything.

[whistle]

3. Suck as in parasites, health insurance companies have sucked the

....life blood out from America's health-care system and sacrificed the majority of Americans health and well being to the Golden Calf of Greed

[CrispyQ]

4. Write that up into a LTTE.

We need to get this message through:

"...my health insurance company is making decisions about my health that have a serious negative effect on my quality of life over money and money alone."

[Crunchy Frog]

delete.

[Crunchy Frog]

6. Well gosh, you wouldn't want to live in a country

where a government bureaucrat comes between you and your doctor, would you? :sarcasm:

Seriously, would you possibly be able to go to Mexico or Canada to get those pills?

[KatyaR]

7. Don't you know that you really don't need them, that you just have to take

what you can get and be happy about it? Besides, migraines can be faked, so we don't know if you really have them or if you just want the medication. I'm sure their underwriters can PROVE you only need 4 pills a day instead of 9. :sarcasm:

I've never understood why things like back problems, migraine, and depression seem to be more highly scrutinized than other issues. I guess insurance companies think it's too easy to cheat them out of money for these illnesses.

Good luck to you--I'm sorry you're suffering so.

[Sadie4629]

8. Migraines

My mother had them, and that was in the days before there were any medications.

I have them rarely, and they are generally of very short duration. If I "catch" them early enough I am able to take a handful of aspirin and kind of prevent the real pain. I have been very lucky. I'm telling you this so that you know that I do understand the kind of intense pain you are dealing with.

The daughter of a close friend always ends up going to the E.R. They give her a shot of something, she sleeps for a full day, and then she's fine.

All that said, have you considered diet as a contributing factor to your headaches? My mom always thought that chocolate caused at least some of her migraines. Nitrates (or nitrites?) are also bad. So is MSG.

I assume the OTC's that are now available don't help?

Your insurance company is seriously screwing you over. Find out how they'd like to pay for a couple of E.R. visits per month. They may find out the meds are the cheaper way to go.

(My insurance co. wouldn't pay for a back brace when my son had a compression fracture of a vertebrae a few years ago. Called it an "orthotic device," and said they don't pay for orthotics. I pointed out that the alternative was to have him in the hospital, probably in traction, for multiple weeks until the thing healed. They paid for the brace.)

[gollygee]

12. They're mainly hormonal

when I was breastfeeding and not menstruating, I didn't get them. And I get one to two a month because one a month is always when I get my period, and then sometimes I'll have a trigger - I've eliminated my food triggers (chocolate and alcohol), but being out in the sun can trigger them and I really try to avoid that but it does seem to happen unexpectedly sometimes, and stress can trigger them and my parents are visiting. Anyway, I've had them since puberty, and I've been to doctors and I've been very well tested and have a good understanding of what's causing them.

I'm planning to get pregnant again soon so this problem will go away for a while, and I can't take the medicine if I'm trying to get pregnant anyway, but it makes me angry. I should tell the insurance company that I decided to get pregnant, have a very expensive birth, and create a new person for them to cover (and we're already paying the family rate so they won't actually get any more money) because being pregnant and breastfeeding will make it so I don't get the headaches for that period of time

[napi21]

9. Yes they all suck, but I have something you need to checkout.

It MAY help you.

I heard Clark Howare (A consumer advocate with a daily talk show) describe how several different Companies price their drugs He started the conversation by stating that you could by a month of XXXXX (sorry I don't recall which example he used) at Walmart and the cost would be $44. If you went to Costco or Sams the same drug supply would cost $5.

He explained that it boils down to how the diff. cos. set their pricing. On name brands drugs, there's is VRY little diff. in cost no matter where you go because the margin is so VERY VERY LOW, but generics are a differnt story. The Wallgreens, Walmarts, CVS etc. all price their generics as a discount off the name brand, but Costco & Sams do the opposite. They price their generics at cost + 10% to 14%.

I don't know if it's possible to work with your doctor and fight the ins. co. on this, but if the drug your Dr. prescribed for you is available in a generic form, MAYBE you would be able to afford a few more doses per month...at least until you can convince the ins. co. they're unreasonable!

BTW, here's a clip from his show. Pretty amazing info!

Mar 22, 2007 -- How to get the best deal on prescriptions
The Wall Street Journal has done a research project on prescription drugs, showing the disparity in the industry. The price difference – even between generics – is huge. The last survey found Costco Wholesale to be the cheapest. This time, it was Sam’s Club with Costco coming in No. 2. For example, Zocor is $90 at Walgreens, $80 at CVS, $12 at Costco and $6 at Sam’s Club. The generic of Zoloft was $74 at Walgreens, $70 at CVS, $6 at Costco at and Sam’s Club it was $5. So what’s happening? Instead of pricing generics up from the wholesale cost, places like Walgreen’s and CVS discount from the cost of brand name drugs. So, a generic may cost them $3 at wholesale, but they charge $70 or $80 because it’s still less than a brand name. That’s why CVS and Walgreens push generic drugs so hard. They make a ton on generics because they mark them up so much. So, it’s clear that filling your prescriptions at Costco and Sam’s Club is the way to go. If you’re worried about being a member, don’t worry. In many states, you don’t need a membership to get prescriptions from those warehouse clubs.
http://clarkhoward.com/shownotes/category/11/98/

[Warpy]

10. In a weird way, being uninsurable for 20 years has given me

a little bit of an advantage over people who are new to the denial game.

I know how to ask for generics. I know when to ask if a patented drug has an older, generic equivalent. Yes, the new one is improved, but does the generic work? I know how to turn down Zithromax in favor of antibiotics I have to take four times a day for 10 days and I know enough to finish every last one of them. I know that it costs about the same for a complete metabolic panel (bloodwork) as it does for the less informative basic metabolic panel. I know which labs are cheaper. I have an idea about what can be managed at home, what needs an urgent care walkin and what needs a fast dash to an ER.

Do talk to your doc about both cheaper meds and about what can be done to kick that insurance company in its corporate ass to tell them that one size does not fit all.

You still might need to bite the bullet and pay for your own pills, though.

Insurance companies are the problem. Nothing that keeps them in the mix will be better than a bandaid on a compound fracture. We need expanded Medicare NOW. Nothing else will do.

[hashibabba]

11. I used to get those killer migraines, too. Partly hormonal

but probably other things, too. I finally talked a doctor into giving me a migraine medication and it worked like a charm! The only thing is, I didn't have health insurance and it cost me $200 for nine pills. Of course, I only needed to take one and the headache would be completely gone, no sleeping all day, no *hangover* the next day. It was wonderful. Fortunately my hormones changed and I don't really get real migraines any more, although I do still get *sick* headaches including an aura. I don't care because the pain isn't as bad as it used to be.

But I know where you're coming from. I had a CTscan years ago and it showed the blood vessels were enlarged. That's proof. They can even tell now with PET scans that people are depressed. There's no reason for the insurance company to be like that about your medication because you already have proof. I also had *proof* on my back injury. There will always be people who abuse the system, but that's no reason to keep people who really need it from getting their medications.

I think its a good idea to have your doctor step in for you on this matter. Also check out with the manufacturers of your medication if they have a program to give you the medications for little or no money.

Good luck, I know how lousy those headaches are!

[NMMNG]

13. I've had the same rationing problems with my insurance companies

But there are ways to get around them.

For example, I can only get 9 Imitrex a month which generally isn't enough. However I can also get 9 Maxalt a month. Therefore I've just doubled my monthly supply of medication. As long as I don't break the safety rule of taking the two different medications in a 24-hour period I'm fine. You could check to see if you can get any two (or more) different medications and max out on them at the same time to get around the asinine bean-counters' quotas.