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667078 tn?1316000935

Phone Ping Pong Anyone?

SS has a discount program to help pay copay. I applied and was accepted in May. SS said call right before you call the pharmacy for refill and they will handle it. So I did yesterday. SS calls me back today and says my mail in pharmacy (the only pharmacy my insurance plan lets me use) does not honor SS discount plan. I call the Pharmacy, they say they will honor it but they got 800 applications from SS and they are still sorting them out. I call SS back they say they will not honor it if my application is not processed by the pharmacy when I refill next week.  Why can't they honor the discaount from the time they approved you? This is a company which has made over 3 billion in the U.S. this year .Even if it is approved a week after by paharmacy I am out of luck. This went on for hours. I then had to apply for another kind of assistance from SS which takes over a week and I may not get.

If this happens to you remember to sing  YOU CAN GET ANYTHING YOU WANT AT ALEX'S RESTAURANT , except a discount! lol
Alex
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667078 tn?1316000935
I am still waiting for further paperwork for Shared Solutions assistance.


I finally gave up on SS and went order my Copaxone from medco and pay $100 for a month. I asked if they could give me an idea when they would work out the discount plan. "We do not have a time line"

They called me back and told me they were going to hold the shipment  of copaxone until I had a couple of syringes left I have eight because it was a "Special Order".

I said I want a supervisor. I said I think its time to get BCBSNC involded since you are the only pharamcy they use.

She bent over backwards. Called Shared Solutions.  Said I could do a payment plan.
Then to my surprise she called back after talking to a supervisor at Share Solutions and told me I would get the original discount plan. They were up to May 15 in processing and I am May 28th. Shared Solutions approved me on May 21st. They would hold sending the bill to Shared Solutions until I was processed.

A week and many many phone calls the catch 22 solved I hope.

When it rains it pours. I went into my bathroom in between calls this morning and my roof was leaking. At least the roofer was there in an hour. His crew will fix it tomorrow. LOL

Alex




Helpful - 0
559187 tn?1330782856
Ooops...Green means go for cars not necessarily for people.  Sorry for that goof.  

Be Safe,

Julie
Helpful - 0
559187 tn?1330782856
I am so glad to hear that copay program worked out for you.  I started writing a response to this program the other day but deleted it because i was being to negative and unhelpful with what I started to say.  But the jest of it was exactly what you had already mentioned and that is the privacy issue.  The wording on the application said I had to "agree" not to go off the medicine without my doctor's approval.  And that approval had to be routed through them (SS).  

I may have misinterpreted that, but that was how I understood it.  I pay $35 a month and now hearing about your having to pay $100 I will pay me copay and leav the program to people who need more help with their copays.  That is a lot of money and it adds up.  So, again, I am happy you will get in the program.  Good for you and thanks for the information you found from yoru research.  

Take good care and remember "green means go".,   We can all relate to that.  :=)

Love and hugs,

Julie
Helpful - 0
572651 tn?1530999357
Hi Alex,
That SS came through for you is great news.  I will keep my fingers crossed that this all works out.  Every little bit of assistance really adds up.

I know my copax copay is $50 a month, which doesn't sound like much but it comes to $600 a year.  That is not the only drug I am on.  And then you throw in the drugs that my DH is also taking, and we are putting out considerable amounts of $$ just for our copay. Fortunately I got rid of my other $50 copay drug, which was a specialty heart medicine.  And my Lunesta lasts a long time for me - that's another $50 monthly copay.   I have  stopped taking it nightly.

This is really good news for you.

congrats on following through successfully,
Lulu
Helpful - 0
611606 tn?1315517767
So happy you received some good news from SS... Hope all works out for you{{{~!~}}}
Helpful - 0
667078 tn?1316000935
I woke up feeling much better.


SS called again today said I am probably approved for there assistance program. They will send me paper work and it will take awhile to set up. I have 12 injections left. My Drs. office said they will see what they can do to give me samples until mess is straight so I do not have to pay $100 for a month supply.

Thanks for listening to me vetch.

Alex
Helpful - 0
611606 tn?1315517767
Hi There, gosh this is so hard, but try  to hold on to the fact that it will get better. Stress is so hard on us, it is hard on so called "Normal" people,( let me know when you meet one) . ;-). But when it hits those of us who deal with MS, it hits even harder, and the effects can be awful.
I too am so proud of you, that you stopped driving while you are feeling this way. Goes to show you your mind is still working.. Seriously if it weren't you'd still be driving..
You hang in there, things will be better soon... Just don't ever give up on yourself... We are all here for you...
{{{~!~}}}
Helpful - 0
572651 tn?1530999357
Alex,
All of us thank you for being wise enough to take yourself off the road.  My guess is this is a temporary stress induced reaction to all the c rap going on in your life right now.  when you get settled into this new normal, your ability to think and concentrate should improve.  

I am glad the truck driver recognized your dilemma and left you unharmed.

feel better,
Lulu
Helpful - 0
667078 tn?1316000935
Someone from SS called today she said is Alexandra there? I said yes. May I speak to her? I said yes. Well can I speak to her? This is she. Can you verify that you are Alexandra by your date of birth?  Then she said I hear from the SS nurse you are interested in the Discount program have you applied? I went through everyone I talked to and what they said yesterday.  They won't call back. Arlo Guthrie where are you when I need you?

Unfortunately my old buddy depression is back with a vengence. I was walking my dog and got to a stoplight and could not remember what to do. The light was green and I stepped out in traffic until I realized green means go for the cars not pedestrians. A truck was real nice, he seemed to realize I was not working on all cylinders. I can't drive either. Its like something snapped in me yesterday now I do not care where the car goes. My brain feels weird and I just don't care. I am not driving until I am better for everyone's safety.

Alex




Helpful - 0
611606 tn?1315517767
Thanks for the info. I agree with you.. I don't like the idea of my info going to who knows where.. Too much like "Big Brother lurking"
Helpful - 0
667078 tn?1316000935
Been doing some research. Seems the SS Discount Plan may be a way to get more data on folks on Copaxone. It is a sweepstakes in a way. When a patient signs up you sign a medical release to share information. Once they have your John Hancock they can use your info for their data. Very few pharmacies participate and there is another loop hole for payment. It goes back at least to 2005 so they should know how it works by now. It is kinda like signing up to win something from a business and the business in turn gets your info. Its probably legal but not really nice.

I for one will not be answering when SS calls in the future. They drive me nuts anyway.

Alex
Helpful - 0
611606 tn?1315517767
This is the first I have heard of these programs. but I am Medi-Medi, so Most of the time my Dr.s get their scripts changed by the Insurance Co. and they have to fight if they are determined that I take a certain drug. I feel very lucky that I have Insurance at all, so I don't feel like I can complain, except when I have to fix my wheel chair with Duck-Tape ;-)  ( Hey it works). I signed up for MSAA and printed out the forms for Dr. Patel. I think they might be able to help me with the Chair...
{{{~!~}}}
Helpful - 0
572651 tn?1530999357
I struck out with the SS cost sharing immediately because my insurance - Anthem - required me to use their specialty mail order pharmacy, which is not a participant in the SS plan.  So I pay the $50 co-pay each month on my own.  

None of this help makes sense to me because it sounds like next to no one is getting $$$ assistance.  


Does anyone here get help with their drug cost through these programs?  

Just wondering,
Lulu
Helpful - 0
338416 tn?1420045702
I've had the hardest time getting SS on board for the discount program.  I signed up initially for CVS, then found out that they will only work with the specialty mail-order pharmacies, not the retail outlets.  So I signed up again for the CVS specialty pharmacy, but my insurance only works with the Aetna pharmacy!  Grrrr...

So I threw up my hands and gave up - for now.  I'll probably try again in a few months.
Helpful - 0
739070 tn?1338603402
Sorry you are getting the run around. It doesn't make sense that SS approved you knowing which company your meds are supplied by. The SS person I talked with had all my info right in front of her including my pharmacy name when we spoke.

I agree that they should honor the disvount from the time they approve it.

Hugs and shots,
Ren
Helpful - 0
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