Re: The insurance saga continues......

[Guest guest]

I have had exactly the same problem with SPOC. I had to choose to pay

35% of the cost of the shots with the pharmacy coverage (2 shots twice a

month at 1500.00 a shot) or put it under the medical side in which I

only pay 20% of the cost. I made the decision to use the medical side

of the insurance and have more each month. With all my other expenses I

have been reaching my deductable limit around May or June and the rest

of the shots are covered at 100 %.

The problem I may encounter is that in October the state insurance is

changing. Premier Blue is being dropped in favor of another type of

Blue Cross Blue Shield option. I will find out in October whether this

option is still available or the shot will not be covered at all. If

the latter becomes the case, I will simply have to quit taking the

shots. That would be too bad because I believe the shots are doing a

great job with my asthma along with the other allergies I have. I have

not had to use my inhaler for months now as long as I take my other

medications.

Wish me luck!!

Steve Zimmerman

Have a Good Day

785-296-6947

________________________________

From: [mailto: ]

On Behalf Of

Sent: Tuesday, September 25, 2007 8:38 AM

Subject: [ ] The insurance saga continues......

FINALLY got the BCBS only to find out that Xolair is NOT included

in our " pharmacy plan. " HOWEVER it is covered as a " medical

expense!!! "

UNFORTUNATELY..I have an individual deductible of $3,000 per Benefit

Year !!!! Meaning I need to pay a break down of $3,000 to get my

Xolair for the Months of Oct, Nov, and Dec. THEN start all over

come Jan 1st 2008. I guess the up side is that once the $3,000

deductible has been paid in 2008, Xolair will be covered at 100%.

BUT...having to come up with $3,000 by the end of this year and then

start all over again next year.....it's a Catch 22. DO I choose to

get the Xolair and not pay my mortgage and then risk losing the

house?!?!? OR pay my mortgage and risk ending up in the hospital

because I had an acerbated asthma attack?! I have talked to SPOC and

we're " working on " an arrangement.I just did an injection on the

20th. Luckily I have enough for one more round on Oct 5th, guess

I'm good till Oct 19th!

The fiasco with COBRA has still not been settled. What a joy it has

been to find out that HR person at the former job, never bothered to

pay CIGNA the $1,900 per month for COBRA since April. Gotta LOVE

the paper trail that canceled checks leave!!!!!!!! This is why you

NEVER throw out cancled chacke and bank statements. (The HR person

is no longer employed by the former job and the former job is now

under investigation for Insurance Fraud!)

[Guest guest]

How about calling Genetech and asking about patient assistance programs?

Karin

[Guest guest]

That's who SPOC is.

--- Karin Melvin <nnmfam@...> wrote:

> How about calling Genetech and asking about patient

> assistance programs?

> Karin

>

>

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