Guest guest Posted February 26, 2009 Report Share Posted February 26, 2009 I check with the hospitals around here when I was first diagnosed, didn't have insurance at the time. I found that one offered a 60% discount when paying cash. The I found that the lab would match and discount the hosipital offered. Still, it cost a bloody fortune! It might be worth checking. Stan, Seattle, Rainy. [ ] My new Rheumy I have been having a problem with my regular Rheumy since I switched insurance from Medicare to Texas Community Care at the first of the year. His office wouldn't renew the contract with them, so I had to find another Rheumy or change insurance. This one seems to have a wonderful benefits package, zero co-pay for scripts ordered through their pharmacy on any generic, zero co-pay for seeing the PCP, $5 co-pay for eye exam and $150 toward glasses, and a number of other things, dental and all. And, no premium except for the normal Medicare amount. I agonized for a while deciding what to do, but even though the Rheumy was with me for almost 20 years and worked well with me (or so I thought), but I finally found a local Rheumy that would take the insurance. I saw him this morning and he wants to switch me to a biologic and get me off Prednisone, things my other doc didn't do or suggest. He also wanted me to have a hand x-ray and MRI to tell how much is osteo and how much is RA. I went to the hospital for the hand tests and they wanted an arm and leg before doing only the x-rays. It was certainly more than I could pull out of all my bank accounts. Now I don't know what's going to happen since I couldn't afford the tests and can't get the doc on the phone so far. -- Dennis in eastexas Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 27, 2009 Report Share Posted February 27, 2009 Hi Dennis: I sure hope you can get those test done, and not go broke. You must be so frustrated with all that ins. mess. I hope you can get a better plan, and have a Rheumy who understands your ins. problems, and works with you, not against you. Wishing you pain free days ahead. God Bless you and Betty. Hugs, Barbara > > I have been having a problem with my regular Rheumy since I switched > insurance from Medicare to Texas Community Care at the first of the year. > His office wouldn't renew the contract with them, so I had to find another > Rheumy or change insurance. This one seems to have a wonderful benefits > package, zero co-pay for scripts ordered through their pharmacy on any > generic, zero co-pay for seeing the PCP, $5 co-pay for eye exam and $150 > toward glasses, and a number of other things, dental and all. And, no > premium except for the normal Medicare amount. > > I agonized for a while deciding what to do, but even though the Rheumy was > with me for almost 20 years and worked well with me (or so I thought), but I > finally found a local Rheumy that would take the insurance. I saw him this > morning and he wants to switch me to a biologic and get me off Prednisone, > things my other doc didn't do or suggest. He also wanted me to have a hand > x-ray and MRI to tell how much is osteo and how much is RA. I went to the > hospital for the hand tests and they wanted an arm and leg before doing only > the x-rays. It was certainly more than I could pull out of all my bank > accounts. Now I don't know what's going to happen since I couldn't afford > the tests and can't get the doc on the phone so far. > > -- > Dennis in eastexas > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 27, 2009 Report Share Posted February 27, 2009 This Rheumy seems to understand the problems. I did finally get a call back from his nurse and she said they felt ok about my not doing the x-rays and they do the MRI in-house. I had been apprehensive about not doing what the new doc wanted and it would look like I didn't want to cooperate. Fortunately, it's not a problem so I'm still in his good graces. The last time I heard, x-rays cost about $50, not $650! I think I was getting played by the hospital, so I'm checking into having it ordered by my PCP so I can get it done at my regular hospital. They don't always bill me for things. And, I'm sticking with the plan, not the doctor who thinks money is more important than the patient. The Rheumy is supposed to be checking with my insurance about the biological meds and see which one is covered. He wondered why I wasn't even offered these meds a long time ago. He wants to get me off prednisone by switching away from MTX and onto another med. I don't know that one of the biologics would do that. Betty is doing ok. Last week, we were told that she has COPD and emphysema, and has scripts for some expensive (is there another kind?) meds for it. Since we know the cause of her present condition, we know what she should do and not do. All her life, she's had sometimes terrible bronchial infections with no help from our doctors. Thanks for the concern, Barbara. Dennis in eastexas On Fri, Feb 27, 2009 at 9:46 AM, Barbara <bcreedon@...> wrote: > > Hi Dennis: > > I sure hope you can get those test done, and not go broke. You must be > so frustrated with all that ins. mess. I hope you can get a better > plan, and have a Rheumy who understands your ins. problems, and works > with you, not against you. > > Wishing you pain free days ahead. God Bless you and Betty. > > Hugs, > > Barbara > > > > > > I have been having a problem with my regular Rheumy since I switched > > insurance from Medicare to Texas Community Care at the first of the > year. > > His office wouldn't renew the contract with them, so I had to find > another > > Rheumy or change insurance. This one seems to have a wonderful > benefits > > package, zero co-pay for scripts ordered through their pharmacy on any > > generic, zero co-pay for seeing the PCP, $5 co-pay for eye exam and > $150 > > toward glasses, and a number of other things, dental and all. And, no > > premium except for the normal Medicare amount. > > > > I agonized for a while deciding what to do, but even though the Rheumy > was > > with me for almost 20 years and worked well with me (or so I thought), > but I > > finally found a local Rheumy that would take the insurance. I saw him > this > > morning and he wants to switch me to a biologic and get me off > Prednisone, > > things my other doc didn't do or suggest. He also wanted me to have a > hand > > x-ray and MRI to tell how much is osteo and how much is RA. I went to > the > > hospital for the hand tests and they wanted an arm and leg before > doing only > > the x-rays. It was certainly more than I could pull out of all my bank > > accounts. Now I don't know what's going to happen since I couldn't > afford > > the tests and can't get the doc on the phone so far. > > > > -- > > Dennis in eastexas > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 27, 2009 Report Share Posted February 27, 2009 Gosh Dennis, you guys sure have it tough. I hope the meds. help Betty. That is a nasty disease. Sorry to hear she has it. I think all meds. cost way too much, but they want all that money for themselves. We need the meds, and they want all our money. They sure have it their way. I hope you can get the tests you need and not have to pay anything or at least, a low fee. Your new Rheumy sounds good, and is willing to have you try something else. Good luck with whatever you decide to try. What my cocktail is now is sure working great for me. I am at the max dose of MTX, Sulfasalizine, and Placquenil. I pray this works good all the time for me. I don't think I can ever take a Biologic drug, as I was positive for TB years ago, and took treatment for its prevention. I know the side effects can set off TB of the lungs and bones, etc. I sure don't need that. Wishing you and Betty better days ahead. God Bless you both. Hugs, Barbara > > > > > > I have been having a problem with my regular Rheumy since I switched > > > insurance from Medicare to Texas Community Care at the first of the > > year. > > > His office wouldn't renew the contract with them, so I had to find > > another > > > Rheumy or change insurance. This one seems to have a wonderful > > benefits > > > package, zero co-pay for scripts ordered through their pharmacy on any > > > generic, zero co-pay for seeing the PCP, $5 co-pay for eye exam and > > $150 > > > toward glasses, and a number of other things, dental and all. And, no > > > premium except for the normal Medicare amount. > > > > > > I agonized for a while deciding what to do, but even though the Rheumy > > was > > > with me for almost 20 years and worked well with me (or so I thought), > > but I > > > finally found a local Rheumy that would take the insurance. I saw him > > this > > > morning and he wants to switch me to a biologic and get me off > > Prednisone, > > > things my other doc didn't do or suggest. He also wanted me to have a > > hand > > > x-ray and MRI to tell how much is osteo and how much is RA. I went to > > the > > > hospital for the hand tests and they wanted an arm and leg before > > doing only > > > the x-rays. It was certainly more than I could pull out of all my bank > > > accounts. Now I don't know what's going to happen since I couldn't > > afford > > > the tests and can't get the doc on the phone so far. > > > > > > -- > > > Dennis in eastexas > > > > > Quote Link to comment Share on other sites More sharing options...
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