Patient Rights

[TheFalcon]

Hello all,
   We have called our insurance company to try to get the interferon started. We were told by the insurance company that the injections had to come thru a mail order pharmacy. When we called the mail order pharmacy, they told us the injections were not covered that we had to go thru our place of employment to have the injections filled. The problem with this.....my husband and I are both health care workers & employees of this hospital and know just about everybody in the pharmacy & prefer that they not know our business. Doesn't the pt have certain rights to choose & have their medical condition kept private? The Ribavirin is no problem to get covered at a retail pharmacy, but all the retail pharmacies that we call & they run the Insurance card thru tell us that we need to go thru our employers pharmacy to get covered. Just at whitts end!!! Thanks for any comments that you all might have to help us with this.

[strator]

Wow is right- what a great outcome. Way to go. So many nice stories about real people out there helping out. We usually just think of this PIA entity with insurance and red tape. Mrs. O great thinkin, you really give some great help here.

When I tried to get into detox a few years ago the hospital wouldn't take me because I'd walked out against medical advice a few months earlier. The admitting nurse despite being told wher she worked wouldn't take me, and someone from the management co in FLA that the Ct state insurance I had contracted to, spent hours on the phone trying to get me in someplace. It took til the next afternoon and my doc to get involved(it was a very scary detox). When I got out the woman from the mgmnt co called me at home and asked how I was doing, helped me get an outpatient program. Called me over the next few weeks and told me when the program was over, if I needed therapy or anything she'd set it up. If I just needed someone to talk to call her extension. When I finished the program I had to call and thank her. Turned out she'd been in recovery for years. I haven't been back to detox either.  Sometimes God just puts his stamp on stuff so we know he was there.
Don
Don

[azgrl]

Hey veg I hope life finds you well up there.  You know it's funny you mentioned being on tx and being in a wedding or going....my brother is getting married right after I start tx and I am so nervous that I'm gonna look like some sicko.....I'm not a makeup kind of girl but I think I might be taking some lessons for this occassion.  Funny how we're winding up in the same boat.....aiyyyyy  yai yai!!!

Deb in Az

[vegas777]

thanks,  much appreciated...I knew about the black cohost, I went to a Naturpathic Doc in August, went on a vitamin, chinese herb, doet and exercise regimen, 3 months later had a blood draw and my enzymes sky rocketed, they doubled, almost tripled so I stopped it immediately, last week I have a zillion blood draws and I am anxious to see if my levels went down since I stopped it...

[cajunlady]

Good Morning All,

I could not take the harmone therapy at all.  Too much breast cancer in family; mom and sister both had mysectomies.  I know the patch you named is a commom one they dispense.  Not sure of the other.  I tried Black Cohash(spelling?) with my obgyn's permission, knowing I was Hep C., and it bothered my liver; got off.  I had a 5 year roller coaster ride; honey I can not even begin to tell you that nightmare.  I would ask my hep doc; I don't think others really know all that can not be put on the liver w/HepC.

I have another question.  Since yesterday afternoon I have had this extreme pain in my right side (far right) right at the rib cage. To sit is extreme pain; to stand is a little milder; if I lay down it goes away, but the minute I stand up it's back.  I don't know if I ate something that did not agree with me or if this is something more serious.  Want to get some feed back before I call doc this morning.

cajun IN PAIN

[vegas777]

I have pain in that area constantly, I attribute it to liver pain, even though professionals say the liver has no pain receptors, only other thing it could be is gallbladder, in my case I know it's not gallbladder for I had a ultrasound and it was fine, call your doc, don't wait, it could be nothing but it could need attention as well...

at any rate I hope you feel better soon.

*dippers*

[friole]

First of all, Falcon, there must be some way around this issue. It does not seem logical that you should have to disclose this to your place of employment.  Can you call the insurance company and see if you can be assigned a case manager.


Now I must share this story about my insurance company - BC/BS of Texas.  When I got home from work last night there was a message on the machine to call a registered nurse case manager at the insurance company.  I am taking Pegasys, CoPegasys, Neupogen, and Procrit.  The insurance company has been very very good about paying all the labs and my co-pays are reasonable.  Nonetheless, I was freaking out!  I had just called the pharmacy to refilled a Neupogen rx and my worst fears were that they were going to deny it or refuse to pay for the blood boosters anymore.

This morning I spoke to the case manager.  He was wonderful.  He was just calling to see how I was doing because he knew I was on a difficult treatment.  He said he had volunteered to be my case manager because he had gone through the treatment and has been clear for two years.  I'm telling you, folks, I was overwhelmed.  Not only was he kind and supportive but he answered a lot of questions I had -- Like why was I paying for a 3 month co pay amount on the Neupo, but there were only 10 vials and it will not last 3 months -- answer was the original rx was written to be taken every week or two weeks.  All I had to do is call the doctor and they will call in a new rx for every week.  Asked about the dose of Pegasys I left in my car in 85+ degree day -- he said, no problem, call him and he will get the pharmacy to replace that dose.  Also asked him if, since I was not clear at 12 weeks if I could extend treatment for 36 weeks after clearing -- he said no problem as long as the doctor writes the prescriptions.  Wow - my doc just said, off the cuff, the insurance co would not pay past 48 weeks.

I'll tell you something else.  Other than this forum, I have not spoken with anyone who has Hep C and was on treatment.  It made me realize how lonely this all is - whether you tell people or not that you have Hep C - it is still a lonely road.  I was almost in tears.  When he called me back later, I told him how grateful I was for his call.  He is not only going to be a valuable asset, but he is a new friend.