Health Insurance

[dyce]

Ha everybody,

             I am wondering,the n.p. told me she put in pre-approval for the pegintron ,riba and blood boosters. How long does this usually take the insurance companies to respond or approve it. they put in for it about a week ago.

             Mr.BB, I was wondering, how did your 6th shot go?

Dyce

[friole]

Aaaah the bonds that Procrit make - eh Goof?

[fishdoc]

"As friole was moving towards the flesh of her thighs, I was fucussing on the smooth area of the lower belly."

OK, I can't help myself.... didn't I read this in a book with two people swappin spit on the front....

[Mister beagle bailey]

That is great news, soon you'll be starting tx my friend. Thank God, I know how much you want to get going.

The Beagle

[dyce]

Ha all,
        Got a hold of caremark today,my insurance specialist pharmacy.After i.d ing myself to them,the lady told me my med. team did apply for the meds and the approval would be thru mail order only. Then she gave me 2 phone numbers, told me to give thease numbers to my doc. so he would know approval was for mailorder only.

         I called the Doc. office and talked to 1 of the girls there and she said they always handle the meds. thru mail order and that everything would work out . As soon as the meds come in their ging to call and we'll get things started. Now aleast I know the ball is rolling and it should't be much longer.
          
         Falcon ,what kalio1 said is no doubt a good suggestion. Maybe that would be better for you.

Thanks every1 for the post
                           Dyce

[NYgirl]

My Epogen also comes in tiny tiny 40,000 vials...I am curious about these "big bottles".....

BEST OF LUCK WITH IT!

[silverangel]

I went to a hematologist for procrit. He will be able to give me my injections right in the office. No need for pre-approval. I don't know what your co-pay for meds are, but mine are pretty high, especially if I will need every week. Getting it in the Dr's office, for me, is the best way.

[TheFalcon]

just found out that we don't have mail order benefits with our insurance. I called the HR dept at our work. She said since it is a Bio-Tech medication that our pharmacy can get the medication cheaper & it will be less out-of-pocket for the pt.
Just a bummer because both my husband & I work at this hospital & know everyone. Just would prefer that the Pharmacists not know our business. :(

[mikesimon]

They look good to me also. Your Hmgb has dropped significantly so the Procrit is timely. Best of luck to you Tommy. Mike

[GoofyDad]

As friole was moving towards the flesh of her thighs, I was fucussing on the smooth area of the lower belly. Meaning, of course, that I switched procrit injection site to the belly area. That seemed to do better for me.

Note that the procrit is syrupy thick - that's not completely obvious at first.

Jim posted an instructional post on procrit a while back, I'll see if I can't find it.

[NYgirl]

RE Procrit or Epogen I TOTALLY think this is the only way you can do it with the least amount of pain

SLOWLY - start and stop start and stop.  Also I take it and roll it in my hands for about five minutes to get it warmer...the stuff is a killer but so so so so so so so SO worth taking. My GOD it is a miracle drug.  While I hate the shot I LOVE the medication!

Also make sure they give you VERY SMALL NEEDLES.  The last time they gave me 3s.........what FOOLS!  1s are the biggest you should get and if you CAN find a 1/2 get that!

[honey11]

Hey,,,,I agree with Chev,,,,your lab results,,,overall are looking great for the tx!  You did have quite a drop in hemoglobin from 16 but 10.6 is still not too bad.  Glad you got it straightened out and hope first shot goes well.  It does sting a little but Friole has some great advice there to help prevent.  Congratulations for making it to the 3 month mark,,,You are doing great!

[MrsOckert]

Sometimes it isn't the ins co dragging their feet.  After seeing my hep dr it took his staff 1 week to fill out the paperwork and send it in.  Another week for the people on the other end to realize a problem.  3rd week to get that straightened out.  4th week for me to get involved.  Then finally approval.  The ins co didn't receive the info for 4 weeks.  They would have approved it within 2 days.

Just remember this is the time to be patient.  Your going to have to work with this Dr staff for a long time on TX.

[NYgirl]

Considering there is so little difference really in SVR rate...why not see if they will put through PegIntron?  You haven't started tx yet have you?

[friole]

Neupogen and Procrit sources
Amgen, Inc.
Contact: Amgen Safety Net Programs
Medical Technology Hotlines:
1-800-272-9376 (202-637-6698 in Washington, D.C.)
Drugs Available


That is the info on help for Procrit, but I have no idea if it is asset based or income based financial info they need.  I can only imagine how you feel with a 6 point drop in hgb.  So will you do the shot tonight?  I am curious about the "big bottle".  Mine come in teeny individual vials of 40,000 units each.  Are they providing you with a 3 month supply?

Hints on injecting the procrit -- Let it warm up - at least 1/2 hour before injecting.  Inject slowly, very slowly -- it burns.  I usually keep pinching my flesh while injecting instead of releasing the flesh like the inf. Both Goof and I have described an interesting phenomemon whereby the Procrit seems to meet resistance with the body (doesn't want to go in????)I have never had to change injection sites during a shot but Goof has.  That 40,000 is a lot of fluid, and I just think it takes time to filter into the fat. I use a 28 ga (bigger the gauge, smaller the circumference) 1/2" syringe used for allergy shots. (Duh, maybe that is part of my problem, maybe I should start using a 27 or something). Make sure the pharmacy doesn't give you big long needles! Also, I was doing it in the abdomen/belly and saving my legs for the Peg, but recently switched to the thigh because I think it is less sensitive than the belly.  Now don't let my scare you.  As NYgirl is found of saying, the shot is a B**** but the benifit is well worth it.

good luck tonight, friole bean

[fishdoc]

BTW, my meds are Peg-Intron, but pegasys was listed on the insurance plan also.  I called and spoke directly to Sheila, who is the one that handles the interferon stuff I think...don't have the number here, but if you call the specialty pharmacy, and ask for her, they should be able to send you directly to her..

[dyce]

Ha my friend,
            Sorry to hear your having to suffer thru. a delay like that. It's b.s. people have to wait like this! It takes a lot of thought and sifering to weigh the odds out for considering the tx in the first place. By the way Fishdoc got her meds. thru caremark' her insurance specialty pharmacy, so I don't know whats up with your problem with them. It all seems to boil down to the almighty dollar.

Thanks for your post,
                     Dyce

[TheFalcon]

Hi, I'm having a heck of a time with the insurance. I thought everything was going to be OK last week when I posted. We have United Medical Resources & we need to go thru a "Speciality Pharmacy" in which we were lead to call Caremark & caremark called back today & said the Pegasys is not covered thru them. I called Axium, they tried to help & lead me back to Caremark. The Dr's office called Caremark & faxed over the Rx's & paperwork. I will call UMR back tomorrow. Everyday I start over & over. I need to call our HR dept. Gets a little dis-heartening, at least for us.

[fishdoc]

I just switched from my husbands to mine- blue cross blue shield, and the preferred specialty pharmacy is Caremark.  Others here told me you had to contact them yourself, and it went really well after I did that-but the approval was almost three weeks...and it was a REALLY stressful three weeks at that, especially when they started telling me 10% instead of a flat rate for mail order- and I kept saying if it comes in the mail, thats mail order!!  Good luck, I hope your goes OK.  I think in most cases the "approval" is just a formality, after all we either got it or we don't...

[dyce]

Fish,do you have insurance thru your work? What is the special pharmacy your talking about?

any imput will be appreciated.

Dyce

[fishdoc]

Just went through the same hoops.  Script called in on the 9th, and last thursday I finally got it all taken care of.  I was dealing with some kind of middle man to the insurance, they were telling me I owed 10%, had approval, how was I going to pay.  I fired them, called my specialty pharmacy and spoke with the rep, and I have my meds on ice, first shot this thursday.  I guess it took almost three weeks for approval.... oh, they also cost me $45 for three months supply- moral to the story, nice doesn't get you anywhere...

[Upbeat]

    Thanks.  Thats what I thought. Just making sure.
                                                       Ron

[beamishboy]

my hgb-hemoglobin level- started at 16.2 was 12.1 at 4 weeks now is 10.6 -hence script for procrit...

[Upbeat]

Do you know what the hgb is?

                                 Ron

[beamishboy]

good afternoon all..Dr just wrote me a script for Procrit-i stopped at pharmacy& they called my ins co. got a "need pre=approval".. i called dr's office gave them the pre-approval phone #;nurse called insurance co & got preapproval;i told them which pharm& then called pharm back..they ordered procrit(a big bottle-my insurance may drop me end of march).....soo,good question for today Dyce!! told me may have procrit in tomorrow.....Got my lab results,would appreciate any insights,concerns or wry comments.......thank you All.
wbc-2.4     rbc-3.27     hgb-10.6   hct-30.6   mcv-93.8   mch-32.4    mchc-34.6    rdw-13.6   plt-132  mpv-9.3  ne%69.5    ly%21   mo%7.8  eo%1.3  ba%0.4  ne# 1.5  ly# 0.5  mo# 0,2  eo# .0 ba# .0       creatinine-0.8       ALT-24 AST-23  
hope thats all you need to congratulate me-lol.....no results on 12 wk vl for probably 10 days.....i am kinda concerned w/ my need for blood booster-whatwith med. insurance shake-up.......anyone try qualifyin for free procrit?? seems to me -as i'm not workin-if program is income-based(not asset) i would qualify??