Low-Cost Options for Migraine Patients
It is a beautiful, calm, and rainy spring morning. Glassy water drops paint the window panes in my room in fleeting, translucent patterns. The water is mesmerizing to watch. The light thumping of the rain against the house, matched only by a ticking clock in volume, lay within an otherwise silent morning air, and it is absolutely serene. The sun is out--- just enough to bring into my once blacked out room a sliver of faint, blueish light---still soft enough so as to be calming yet bright enough to signal the day. The horrid thick yellow pollen is finally being washed away, and I can already feel the air lightening. I take in the moment of beauty, and give thanks for being able to experience it, breathing slowly and regularly. I make a concerted effort to just be still, to have the moment.
I take a look around my room as the world brightens. After awhile, sadness settles in.
Reminders of the cost of migraine
I unfortunately realize that all of the beauty around me also brings with it a rather gloomy, yet familiar scene: I am sitting in bed, recovering (albeit rather slowly), from a multi-day, intractable migraine. The amount of energy I have feels perhaps humorously like it is actually less than none. To my left, there is a stack of medical bills. One from a recent ER visit (note to self: avoid) due to debilitating vertigo that lasted for over 24 hours, as well as other bills from my neurologist, my PCP, and multiple urgent care centers, all for various scans, blood work samples, tests, and conversations that turned up squat in the way of continued migraine relief. They total thousands of dollars. To my right, a laptop screen shows the remnants of anxiety driven screen time from the night before: a few empty search engine results for non-profit healthcare provider options in my area, and an unhappy bank statement reflecting reduced hours at work, and racked up co-payments from too many doctor's visits.
I take a look outside once more before thumbing through the bills, as I begin brainstorming ways to tackle them.
The financial toll
Managing and treating migraine can take a burdensome financial toll on sufferers, particularly when the illness is debilitating and hinders the ability to work. It is estimated that over half of migraine sufferers report that their school or work productivity is severely decreased due to migraine, and migraine patients tend to spend more on average for medical treatment, management, and care than people who do not live with the disability. For many who live with chronic migraine, finding affordable care can seem unattainable. For this reason, I thought I would compile a few resources that may come in handy for low-income migraine patients like myself who struggle to be able to afford to get care at all, due to the inability to work often and the sheer costs of migraine.
Delaying going to the ER
Recently, as previously noted, I had to go to the ER. I really, really did not want to go, and in fact put it off for as long as I physically and mentally could. Even in the midst of a debilitating migraine attack with severe vertigo, almost 22 hours in, I protested being taken because all I could think about clearly was how much it was going to cost to go. It had been multiple days of non-stop pain that came to a head with vertigo so bad that I could not stand for over a day, and eventually my caretaker and a few other friends were so worried that we decided to go. After struggling to get into clothes, into the car, and a horrible, nauseating twenty minute car ride, we arrived. It was the weekend, so primary care, as well as all of the free clinics in town were closed.
Being brushed off at the ER
Unfortunately, visiting the ER does not necessarily mean that the treatment received will be bigger or better than at home options, and I received a low-strength nausea medication and was told I needed to see a specialist. They told me that it was clear that I was not dying (really?) and did not think I needed at CT scan, and sent me off after a very rushed, brief encounter with the doctor. I left still stick, basically being carried by my caretaker around because I could not support myself, and returned home to 'wait it out' in the pain I was in before we went. To be honest, in my case, I wish we hadn't gone at all despite the pain I was in.
ER financial assitance programs
Before we left the ER, my caregiver obtained information about the hospital's financial assistance program. The hospital we went to offers a program for low-income patients where patient advocates can help to lower the cost of visiting the ER, based on income. The forms provided ask for tax information of the previous year, as well as pay stubs of the last three months, and bank account statements. The paperwork and process we were told takes about three weeks, and in the meantime, the hospital bills your insurance for the visit. We were told the financial services office is only open during the week so we would have to return during their business hours.
If you must visit an ER, I highly recommend seeking out information about financial assistance programs that the hospital might have, and asking for a patient advocate there.
Urgent Care costs
My experience with Urgent Care for head pain is pretty bleak. If it can be avoided, I would not go to an urgent care center for migraine pain. From what I can tell, many of the urgent care professionals I have seen just simply are not specialized in head pain, and I have yet to receive satisfying care visiting one. Again, the times I have needed to go to an Urgent Care have been times when my PCP's offices are closed and there is no way to get in with a doctor I know and trust. Usually, at Urgent Care, patients need to pay a co-pay upfront to be seen at all. My last urgent care visit required that I pay over $250 just to be seen by a doctor. Since many of these places do not offer payment plans or assistance, it may be more reasonable to go to an ER, or see if you can reach your doctor after hours.
Negotiating doctor's office bills
When you are seeing a regular doctor, or a specialist who knows you, there are often a lot more options for negotiating your bills and setting up payment plans. This can be a lot of hard work, and it is something I am still figuring out. Many patients are unaware that you can actually negotiate payments and that sometimes there are even errors on the bills we are given. For ongoing treatment, it can be beneficial for patients to talk to a representative about their bills and have them explain what you are being charged for. I recommend bringing up your financial concerns with a representative when visiting and asking for clear explanations as well as for options to pay maybe monthly. They may have payment plans or referrals to outside assistance sources that you can take advantage of, it never hurts to ask for help!
Pharmacy programs for prescriptions
Some pharmacies offer programs for low-income and uninsured patients to receive their medication at reduced or no cost. Researching what pharmacies in your area offer these types of programs, such as Walgreens, may provide options for getting your medication discounted or free. I usually search terms like 'prescription assistance in my area'.
This site also offers information on prescription assistance.
In my area, there are a handful of clinics that offer health services to low-income and uninsured patients who need care. Some of these clinics are volunteer-based, while others are state-funded. It is important to note that in my experience, while many of these clinics are able to treat and diagnose symptoms for common illnesses, they may not be able to treat specialized migraine pain. Still, these can be great places to speak with a doctor without steep costs and discuss your pain, and they may be able to give you more information about seeking out specialized doctors in your area. Searching for free and non-profit clinics in your area could turn up results for centers you could visit.
It is no secret that migraine can be extraordinarily expensive. Between doctor's visits, prescription medicines, lost work days, and management supplies, the price tag on caring for a migraine patient can be rather steep. Knowing different options for navigating the web of costs and care can help make doing so a little easier.
Do you have any recommendations for dealing with the costs of migraine? Let's discuss in the comments!
How much has your migraine disease changed or evolved over time?