Pegasys in December

[OZ]

((((Snowflake))))
Can't you get another doctor??  This one is a first class chump, to say the least.  I cannot believe the way he treated you.  That you had to work with him AKA do everything his way.  Treatment is tough enough without a doctor that won't return your calls, won't work with you, won't bend at least 50%.  Like he was doing you a favor by agreeing to treat you.  Such BS.  
Hang in there.  Don't let him be in control of your destiny.
Donna

[19Dragon52]

(((((SnowFlake)))))

You are not going to believe the crap I ran into today after all our discussion on Insurance & Gastro Doctors!

I had my 12 week blood drawn today for the Insurance to see if my VL dropped enough to continue TX.  My last test came back non-detectable so I wasn't too concerned with this blood draw result.

When I got home from the hospital I had to call my Insurance company to let them know my husband had overlooked the last bill but sent both payments in yesterday.  I did this because someone at the company that mails my TX meds mentioned something to me about an overide payment due 1/20.

I was totally confused and figured I best inquire since I had to call anyway.  We moved here to Niagara Falls, NY from Long Beach, CA 2 Novembers ago.  The Printing Company that my husband worked for got me set up on 36 months of COBRA.  Well, it turns out that the Printing Company dropped Health Net at the end of 2005 so in turn Health Net COBRA is dropping me!  We received no notification from them nor did they notify any of my providers.  Thus...I am going to have some huge bills coming in because everything has been running smoothly and no one knew of this change.

I am having a very hard time understanding why COBRA would commit to paying for a 48 week course of TX when they knew this was coming.  I've been taught in my life to keep committments so I'm not happy about how COBRA didn't follow through and certainly doesn't feel obligated to suggest any options for temporary coverage.  It just amplifies my distrust, disgust & dislike for Insurance Companies.

My husband has finally found work and we will be covered by Blue Cross & Blue Shield in about 2 months.  PROBLEM...I don't know what type of plan it's going to be or if they will cover this pre-existing TX.  Sometimes (fingers crossed) work-place plans will cover pre-existing but I have no way of knowing right now.

I am also dealing with other physical & mental conditions that will just be adding fuel to the fire especially for drug costs!  My husband is going to call out West tomorrow and talk to the 2 people in charge of insurance where he worked and see if anything can be done on a temporary basis.

It will be interesting to see how attitudes at my Gastro's office will be!  I'm not telling any of them that we can pay out-of-pocket, yet.  I just hate putting my husband on the spot with all of this more time.  COBRA has been so terribly expensive but he wanted to make sure I had coverage.  I have ALWAYS been high maintenance when it's come to "medical" care and tonight I am feeling just depressed enough that it makes me feel like my hubby just shouldn't have to always be paying on a dead horse...so to speak.  I know it's my mental state at the moment but I'm feeling like I just don't have the fight in me that's needed and maybe there comes a time when giving up the fight is pretty much the protocal.

I will be praying and leaving that decision up to the Lord, though!

[Helen]

Joyce,
Im sorry to hear of all your troubles, But I can tell you that from what I understand, Insurance will have to cover the pre-existing medical, BUT sometimes the waiting period is up to a year, usually its 6 months, IF you have only lost your insurance for less than 60 days I THINK the covereage is either immediately or the waiting period is 3 months, just check out the policy carefully when you get it.
Its different if your changing Insurance out of the blue
but if your husband has a new job and has medical they have to cover you eventually, I had a problem when my husbands company decided we would have to pay most of our coverage, they would only pay for him 100% and we would have had to pay for me and my boys, which would have run about $430.00 a month, so my boss took me and my boys on, I checked into this thourougly
before changing plans as I dont really plan to work until retirement age so I wanted to be able to get back on my husbands plan eventually, like when my boys are on their own which is a matter of 4-5 years, at the time I didnt even know I had hep, but I still checked this out
and thats how it came out. So i believe this will be the case for you, Im not sure if it changes from state to state, but I realy dont think so. Now wheather they will cover tx. eventually I cant say, but they will cover other pre-existing conditions.
Good luck and keep us posted.

[willy]

Joyce:  What a shock this must be.  Also...... what a pain in the kiester.  Although you may feel like throwing in the towel.......don't.

In Iowa in the middle of the winter......even if I wouldn't pay my utulities bill....... I don't think that they can easily shut off my heat.  Others have medical conditions that make shutting off heat, air conditioning, or electrical and event which can cause damage to the house or to the people in it.

Of course, we are talking about insurance here, but I believe that the same principle applies.   You are in a situation where disruption of your inssurance exposes you to near catastopic events with your health or in your expenses.

I believe that there are remedies to this situation.  They may not be offerring any hoping that you will go away.  I believe that you are entitiled to purchase alike policy or continue what you had; a cobra on a cobra if you will.

DON"T give up.  You WILL have to do extra work in getting it set up.  It may even be different terms, costs etc.  I MAY be completely wrong about this.  I also believe that there is a insurance board of disputes that oversees such problems.  This situation is unique and new to you, but I assure you that it happens to many people, that insurance companies don't want to help them but end up doing so.  I believe that there is a "pool" that they all pay into and that some cases are paid from this.  DO NOT stop paying your policy.  I also believe that they are required to notify you of changes or terminations that effect you.

I also advise ALL to get some sort of auto pay for insurance payments.  If I relied on ME to make payments on time I fail miserably very often.  Our insurance is VERY important to us.  We don't want to risk letting it lapse.

Got to wake kids.....

good luck and hang in there,
Willy

[papa57]

Hi Snowflake,
Sorry to hear of the problems you are having with the doc & insurance. The docs here were very unrespponsive to the seriousness of HCV. I had to ask for a referral to a specialist in Wichita, Ks-about 100 miles away. It was worth the drive to have a doctor that actually knew something about the virus & the treatment. Had to get prior authorization from my insurance company to start the treatment. They had it in a matter of days. I think they just knew the right people to call. Changing insurance may have an impact on the waiting time. Anyway, I would not hesitate to seek a different doctor if he was not showing interest. Peace be with you and take care.          JACKSON      

[Snowflake]

Hi All,

Can't believe all the B.S., i got a call from the doctor office yesterday saying they are still waiting for the information on pharmacy and insurance card. And that doctor was worried,B.S.(about his money maybe). I called them Jan. 6th with member and group numbers and the name of the of pharmacy. Spent two days getting that information so we could get this going. At that time i asked if that was all she needed to get the prescription sent in, she said yes. So i thought i was set.

I recieved my card on Wed., so when i got the message Thurs., i went down and gave them a copy. I asked  about the information i had given her, she said she was unable to get thur and maybe she will be able to do it now. Will see how long it takes for them to call me back. They said they would, ha ha. If they do it will be a first.

I was wondering if anyone suffered from migrains and if so how are they on therapy. I have been getting them again really bad. They mellowed for a few years, now they seem to be coming back more often. I don't know if i can handle them and therapy. Please let me know if yours is worse or about the same?

Joyce, I'm not sure but i don't think insurance can stop covering you in the middle of therapy. Like Willy said keep sending in your payment. I sure wish you the best. I can't believe the things we have to deal with, as if therapy or Hep. isn't enough.

     TAKE CARE
***Snowflake***

[willy]

Snowflake:  I had some tests done in early october.  I KNEW that it would take some time before the bills and insurance was worked out.  I just got my final bill for a test I took about 3 months earlier.  It's CRAZY but wwwhen you get doctors and indurance companies working (and not working  ) in tandem they just move like molasses.  It could be many things....... but don't only blame the doctor.  You see..... they have to jump through lots of hoops and do lots of waiting themselves.  They can't start treatment till the insurance companies give approval to pay for the meds and whatever tests.

Mind you.....it could be the doctor or one of his staffers not completing paperwork.  You might check with the insurance company and see which end the hold-up is on.  If you think the problem is the DOC.....ask the insurance compnay if there are others in your area.  Or just check and ask around.  If they (meaning the doctor and his staff) are incompetant about getting paperwork done maybe they also have other areas of incompetance.  You don't want to find out what those are.    

Some of it could just be the process...... but we've had others that were able to start more promptly.  Still...... it could be something to do with your particular case or your inssurance provider.

best,
willy

[Snowflake]

Hi All,

Hope everyone is fine. I had a bad migrain over the weekend on top of a sinus headache for the last week. Still have not heard from the doctors office about my therapy. I have given the information twice, they said they would call when they got the prescription ordered. As in the past nothing. I am tried of dealing with this doctor and his office. I talked to my primary, whom i totally trust and asked him if he would be willing to do my therapy. He said he only had it in med. school and he was not sure he could give me the care i needed. He is also the only doctor i have ever seen that does not take it personally when you say something about another doctor. I explained to him what was going on with the other doctor and asked if i did therapy with that doctor would he have my back, he assured me he would. And then he told me there was a doctor a couple of towns over on my plan, but i really wanted to try to stay local because i get brain fog pretty bad, sometimes it's hard to stay focused, that's not good when driving.

I would like to ask again if anyone suffers from migrains who are now on therapy. Are they worse???

                                                               Stuck In Limbo


     TAKE CARE
***Snowflake***

[Snowflake]

Willy,

I really think it is the doctor and office help. I had insurance approval in two days after seing the doctor on Oct. 24th. At that time i told him i wanted to start soon as i can, so we made Dec.4th the start date. He informed me he was going on vacation, but would leave the prescription in my file to be sent as soon as approval was made. Well when i called and found they had approval, i asked them to send in for meds.. Doctor had not left it in my file. So when he returned on the 28th of November i contacted him , he said it was no big deal i could get started in Jan., that way i could enjoy xmas. Nice of him to make that choice. It is really hard to make that decession and then have someone else change it. It really messes with the brain. And to act like it is no big deal is the cherry on top. So i told him fine and set a date for Jan.1st. They were to order meds.. Three weeks go by, nothing, so i call. They say , oh i thought you had already started. Yeah right, i am suppose to call them when i get my meds. and tell them when i am going to start. So she says i'll check on that and will call you. I didn't hear from them , seen that coming. Then the last week of Dec. my husband comes home an says insurance is changing as of Jan. 1st. So i get on the phone for two days get all the info. and call them with the numbers and they say thats all they need to get the meds.. Then two weeks go by and i get a message they are waiting for the info on my insurance. UNBELEIVEABLE, so i took them my card i recieved the day before. She said she would call and let me know if she was able to get the order in. STILL WAITING, that was last week. NOTHING NEW!!!

That's just alittle of the B.S. going on here. I have had other things he has not done that he says he would do. He also informed me he does not give pain meds. on treatment, which i never even asked about. It's a good thing treatment doesn't hinge on wheather you like your doctor or not, although it would be alot easier mentally.

     TAKE CARE
***Snowflake***

[jan]

Oh you poor thing, this has been going around and your head for too long. Call the "Be in charge progam" the may beable to help you , they seem to be very caring and could hook you up with a Dr. you like. 1888-437-2608
www.beincharge.com
I went for 3 years thinking about this, my viral count was low , no real damage, geno2b but I wanted to get rid of this.
the first Dr said your fine.no treament needed just live with this eating away at me?
i read a lots and lots!
then i changed my pcp and she suggested a GI, he was a bit elusive & saying I need 48 weeks, i knew better, was he even payng attention?  when i would call for answers , no answer back, so i asked my pcp for another GI. fianlly I will be seen the second week of feb. in the meantime, i will have been on treatment for 7 weeks. but God has blessed me so far with very little sides. I think I am drinking the sides away, but the headaches, ouch! & I can cry of laugh at the drop of a hat. i'd rather laugh.
Please move forward it may not be as bad as you read or think , we are all different. remember you can always stop ifits too bad. but if you never try you'll never know or stand a chace
goodluck!!!! much love Jan.

[Snowflake]

Hi Jan,

Good to hear from you. Yes it has been hard on the brain, you get yourself at a place mentally to get started, only to be pushed back to the start. You feel kind of like a yoyo, don't know if your going up or down. And then no confidents in the GI doesn't help.

It has to be rough for you also, changing your GI while on treatment. Thank goodness you are having few sides. You said the headaches were bad. Did you have headaches before and if so, do you suffer from migrain at all I was wondering because i have started having more of them like when i was younger.

Be in charge is the peg-intron, i was on therapy in 97,INTRON A INTERFERON three shots a week. This time i choose the pegasy's. I have spoke to my primary about another doctor. So far the only other one is a few towns over and i get brain fog bad someday's.

I sometimes wonder wheather i should do therapy or not, i fell so bad all the time. My primary doctor say's i can't keep putting it off, i need treatment now. Due to my high viral load of 18,400,000 and other scores. But i am scared to death to start, i have read a few studies that show when you stop therapy the virus can grow even faster. I'm worried my body won't be able to take it and i'll end up with more medical problems than i already have.

Good luck on your new GI, hopefully you will have a good repore with them. Your old one sounds like mine i have now.

     TAKE CARE
***Snowflake*** 

[19Dragon52]

(((((Hi All)))))

Boy!  This is some start to a New Year isn't it?

Re:  Previous post....My Husband called his old place of work and they had the Insurance Broker call me.  I have to get a Certificate of Coverage from the last Insurance and then go through all the plans another Insurance Company is going to send me and have that ready by 2/13 so there's no lag in coverage.  The new company is giving me a little bit of extended time.  I'm glad there is a possible answer to my dilema but "for Pete's sake!"   I have yet to inform my Physicians...figured I could do that when I'm calling to cancel appointments that were made before I was aware of not being covered anymore.   This is going to take another huge chunk of money out of our account and even though I'm grateful to have enough it really irks me!

I'm hanging in there with you, Snowflake!  Don't these professionals know they're dealing with "DRAGONS?" 

~Hang Tight~
Love To You All........

[Snowflake]

Hi Joyce,

It sure is a bad start, we can only pray it gets better. So Cobra would not extent your coverage untill the end of therapy? I thought Calif. had a law that insurance companies could not stop on going treatment. I guess they do what they want.

If you do not have any lag in your coverage why do you need to cancel appts.? I sure hope they get with the program once you pick your plan.

I really think some of these so called professionals don't need to be treating people. They have no compasion for the suffering we go thru. It seem as thou they feel we have brought this on ourselves and we deserve what we get. Then there is the ones that think we are hiypochondriac. That doesn't leave us many to choose from. Well that's enough of the negative.

I am sending positive thoughts your way, along with prayers.

     TAKE CARE
***Snowflake***

[19Dragon52]

(((((SnowFlake)))))

Tee Hee...You can't possibly think I am going to keep anymore appts. until I hear it from the horse's mouth (new Insurance) that I am taken care of financially for the blind spot in between coverages!   We will have plenty of dollars to hand out to the Pharmacy & the hospital (ironically for the 12 week lab work that the insurance company uses as a meter for covering TX continuation).  I can only pray that once I'm on board with this new insurance they will reimburse us since there isn't supposed to be a lag.  I'm just being cautious right now about adding unnecessary medical bills...just in case!   It won't be very long until I am once again covered (she says this with the ut-most optimism).

To clarify the COBRA situation:  When I signed on after we moved that insurance was an independant extension for the Insurance Company that my husband had.  VERY EXPENSIVE!  But what are you going to do?!   Anyway the company that my husband worked for changed insurance's for this year so the COBRA from the existing insurance no longer would cover us.  I just wish they had informed me.   It was a fluke as I mentioned in a previous post that I even found out.

Now here's the Cherry on the Sundae!  It won't be long after I am all set up with the new policy that my husband's insurance will kick in.  That's okay though because there may be a wait for pre-existing conditions.  I need to tie up every loop hole I can think of.  I guess I wouldn't go through all of this if my tests weren't coming back so good.

Lots Of Love,
Joyce....

[Snowflake]

Hi Joyce,

First, CONGRATS on your test results, thats wonderful. I pray that it continues for you and your insurance gets worked out. Sound like everything is going to be alright.

We had Cobra for awhile, i think in the 80's. At that time they paided 8o%, of their policy, which i think must have been from the 60's. Because it did not pay even half the charge. More like 20%.


Well i got the news Friday, my Pegasy's will be here Tuesday, January 31st. My start date is Monday, January 6th. I have spoke to my shot nurse, she is still able to help me, which is great because i don't know if i could do it by myself. I have trouble with self-injection. That proablly sound silly, but i just mentally have a hard time with it. That is what hampered my therapy the first time around. There is no turning back this time!!!


I spent the weekend doing yard work with my husband and brother to get cleaned up for spring. Pruned seven tree's, apple, peach, mullberries, cork oak and hedges. Felt pretty bad but got it done. Sure made my liver hurt, still hurts today, but does feel some better.


This week i hope to cook some things to put in the freezer for when i don't feel like cooking. I have already started stocking boxed goods like Banquet Homestyle Bakes and Uncle Bens rice that i normally don't buy, in hopes that my husband can prepare it. My husband is very limited in his cooking skills. He can make scrambled eggs and toast. He can also BBQ meat but thats as far as it goes. Hopefully i won't get to tired of eggs.lol


     TAKE CARE
***Snowflake***