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Little Vent about Insurance and the New Year

  • By Pump2Duncan

    So new year = new medical insurance plan. Last year, at the insistence of my doctor, I finally caved to trying preventatives. I was a hold out. And the first few didn’t work so well. And the first couple months of Topamax was weird, but finally the side effects are lessening and so are the migraines.

    So when open enrollment happened, I figured I’d be seeing my doctor a lot more in 2018 to tweak my treatment plan. Having some success with topamax gave me some hope that even if topamax doesn’t turn out to be the final answer, I wanted an insurance plan that covered more than my 2017 plan covered. So I picked a more comprehensive (more expensive) plan. The preventative I’m on now, plus my Immitrex have a $0 co-pay and my doctor has a very low co-pay. YAY! All looking good. I’ll pay more for insurance, but the trade off would be I wouldn’t have to worry about how to pay for my medications.

    A friend of mine with a different chronic condition recommended I get my preventative pre-filled before the beginning of the year, just in case there was a glitch in the insurance plan switch. I tried, but my insurance said nope, rejected the pre-fill – saying I was filling it too soon.

    And now it’s the 4th. And there’s a big glitch. The insurance company is back logged. They don’t have my change in. So I don’t have that new plan coverage yet. I have zero coverage. They SAY they’ll back date the coverage, so their recommendation is for me to pay out of pocket and then ask for reimbursement from them when they finally do process my coverage. OH GEEZ thanks! I’m SUPPOSED to go back into my doc this month for a re-check to see how I’m doing on my current preventative to see if I need an adjustment. OH and the preventative runs out in about a week and a half.

    OK – deep breath, trying not to stress. But DANG IT!

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  • By Nancy Harris Bonk Moderator

    Hi Pump2Duncan,

    That’s SO frustrating! I’m sorry to hear you are having a difficult time with insurance coverage. I’m sure it will be sorted out eventually – hang in there!!

    Here’s to a stress free month!

    Nancy

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