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HIgh medical costs and how to deal with it

meydey321mmeydey321 Posts: 2,435
edited 06/11/2012 - 8:25 AM in Pain Medications
Hi everyone

I am interested in how do you all cope with expensive medicine costs and office visits/procedures in this tight economy. Has anyone had to cut back or change medications? Any experiences on how you can or can't manage costs is greatly appreciated.


  • dilaurodilauro ConnecticutPosts: 9,715
    Keeping costs down! (Only speaking for USA)
    The problem has some flavor of what came first the chicken or the egg?

    Insurance premiums have been climbing higher and higher over the past 10 years. At one time, major companies provided Medical benefits to their employees at no cost. That a changing scene now. Health premiums keep going up and up.
    What used to cost $750-$1000 for a family of 4 is now costing $5,000 for a family of 2.
    Insurance premiums have gone up through the rising cost of medicines for starters. Medical professionals, doctors now have to pay an unbelievable amount of money for malpractice insurance. SO, that in turn forces them to raise their costs.
    Then since in the United States medical institutes can not turn away medical care to someone in need. Someone has to pay! Those costs are passed on to us in many different ways.
    I heard of the amount of money just our local Hospital losses for people who cant pay, the dollar amount blows you away. So take that and multiple across the nation.
    All of this adds up to higher costs to the individual for everything

    But how do we manage this? For spinal patients and many other chronic pain sufferers, we just can't say forget it, we cant forgo treatments, we cant forget about our pain medications, etc. And if we do that, we open ourselves
    op for more serious problems that will cost more in the long run.
    I dont know how to cut back in these areas. But I do know that without insurance, its just about impossible to pay for medical coverage.

    My son is a chef and has his own business and as such does not have any medical insurance. He took the stand that because individual health insurance premiums were so high ($2-4,000 month) he would gamble. Well he lost. He had some gastro problems and his bills between the procedures and medicines are up over a $100,000.
    To get by, he has to shop around for the best deal in prescription drugs, checking for generics or other substitutes. One medication he was taking was the same exact medication my wife has taken. We pay $10 copay for it, he had to pay $250 for the same amount. Doctors ask him to come in for follow up visits, he tells he just cant afford it.

    So what does this say?

    If you have insurance, you will have to deal with the increase of medical coverage each year.

    If you dont have insurance, I really dont know how you can continue.

    None of this is easy and I only am afraid it will get worse
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • It's a shame that in this country that someone as hardworking as your son with a good profession is uninsured. I don't know the remedy and I won't get political O:) I do know about Humana One for individuals; hopefully it's less costly. I've been uninsured before because we couldn't afford COBRA premiums, and I know what it was like. Medicare isn't perfect, but it's surely better than nothing.

    As far as what came first, the chicken or the egg? - All I know is that we are getting fried.
  • I could give you a list of reasons why I'm glad I will never have to deal with them again. I would keep shopping if I were you. Let me just tell you. I had ACDF surgery for which they are refusing to pay for anesthesia. I guess they thought I should have that type of surgery wide awake. X(
    I have insurance and I still have to make deals with doctors and hospitals. They are sometimes able to make payment arrangements with me that match my income. Some hospitals even have the ability to reduce or even forgive some of the expenses if you fall under their guidelines for approval. But if we aren't healthy individuals then we can't work and then we are in even bigger trouble.

  • Well I am on SSDI, in my state, all the supplemental programs exempt me because at 37 I live at home.With my minimal under $700 #o I rarely make ends meet and something takes a cut.Pain is my issue now, so I get those meds first and food.My diabetes, I focus so hard to keep it level and get the necessary 6 mos. blood tests to confirm.All the test and doctor bills are piled up, I have to cut my Rheumatologist off w/o him truly telling me if some form of spondy-arthritis may be the root of my pain.I still do not have some symptoms- yet and more often than not it takes a few years for a correct DX.
    My bipolar, I have a stockpile of samples to get by for a month or 2.

    Currently, I am considering a part time job, if anyone will take me.My moods are worse than mother nature, no focus and back/leg pain added yikes!! But I have to do something!!!
  • My husband and I are self employed as well and just this past spring decided to stop gambling that we would stay healthy (hitting 50) and got health insurance. One reason we decided to get it was because of my back. Although workmans comp. is paying for this it made us realize that any health issue could bankrupt us.

    We are paying 516.00 per month for the two of us and I think its pretty good insurance. Its picked up all my scripts with a $10.00 copay and office visits are 30/70 and I think we have a 3,000 deductable.

    The pre exising condition expires in February so if workmans comp drops me than I will turn it in to insurance, I may do that anyway, I don't feel I am getting treated fairly because its a workmans comp claim.

  • I went to pick up my meds and found out that I fell in the doughnut hole and had to pay full price. And I had just one more month to go. I'm just going over to another plan on the 1st of the year. Now I have to figure out how to pay for December.
    Frustrated. have you tried a mood stabilizer like Tegretol or Depakote? Zyprexa is an antipsycotic and it is known to cause diabetes. I heard they have a lawsuit against the manufacturer. I hope something out there will help level you out; I have a relative with it and I understand about the mood swings.
    Tomycat, are you kidding me about the insurance not covering anesthesia? That's outrageous and stupid. Run from them-quickly. Suziee, Workmen's Comp is never fair.
    I believe that once you have back problems, you'll never quite get out of hole, with everything we have to pay.
  • Yep, I have a feeling my health insurance will put up a fit when it comes to my back problems. I had know idea it was that big of a deal until we applied for insurance and the agent said that being on hydrocodone for back pain was going to raise some red flags. I have since found out that most doctors don't want to touch you if you have chronic pain especially if its a workmans comp claim.

    Alot of our clients are doctors of some sort and I am hoping that they can pull some strings and get me in to see a good doctor in the future.

    I just got a letter from Workmans Comp and it said that I was depressed and they didn't cover that but if I wanted to see a shrink they would consider paying for it. I am already seeing one, I wonder if they would start picking up the tab.
  • My sincerest heart felt "I am so sorry". I have now read heard and seen so many people who just absolutely cannot get the treatment that they need because of it. It breaks my heart. I read Worker's Comp in somebody's post and I just cringe because I know how they are being treated.
  • That is frightening that back pain would be held against you. I've never heard of so much bias towards a condition since the HIV virus- really. Renal patients get the treatment too. It's like no one wants to deal with the very sick or debilitated and people are stigmatized by taking pain medicine. And Workmen's Comp isn't a joyride either. If you're on it, people (and docs) are prone to think you're trying to milk it for all its worth. It only takes a few stupid malingerers to ruin the barrel. I couldn't handle knowing that I was being videotaped; nobody likes the feeling of being watched and their privacy invaded. And everything you say recorded in order to catch any discrepancy. No way. Thank goodness I don't have to deal with them.
    I think Workmen's Comp are the ones that need a psych evaluation because they are so messed up and can't figure out that patients with chronic pain feel down because of the pain and also because they have to deal with incompetency.

  • Sadly, I had diabetes before the zyprexa though I did gain 20 lbs in 2 months and slept all the time.I save them only for the really bad manic rides for now.

    I just avoid prozac, of all the ssri's, this one turns me inside out and mean.
  • expenses this month and its killing us. No unemployment just yet and I am piling on the debt with credit cards. I picked up my meds today for the month and it cost me $488. I about died.

    I am really hoping he gets a job offer soon and they offer insurance right away - otherwise its going to be critical. I went for medicaid and we didnt qualify IN CASE we get UE...its BS.
    We did qualify for a state program named Family Health Plus however right now they havent even started August's applications so that puts us at February to even be considered. And they dont pay back for prior months. Either way I feel like I am taking it from all ends.

    This economy blows...and its about time that something is done about it otherwise debt is going to ruin this country and everyone in it.

    Sorry to be such a negative nancy.

    Have a good night.

  • I haven't bothered to check, but it would be interesting to know what the annual profits are for insurance companies and drug companies. Everybody is angry now to see how much these CEO's of GM, Ford, and all the banks and investment companies we are bailing out are making every year - but what about the drug companies CEO's? I'd really like to know.

    My insurance is pretty good. They have covered every penney of my tests and procedures - MRI's and epidurals and such. And I give doctors a break with there high fees because I know how much they spent on med school and how hard they worked to get where they are. And of course their high malpractice insurance. But my Lyrica cost $400 a month - $100 copay. How the heck can it cost $400???

    I don't think I'm for nationalized health care really - but I do think the government should do some serious investigating into some of this. I don't think people should profit quite so much from other people's misfortune. I know we are a capitalistic nation, but it seems these medical companies have a monopoly that needs to be addressed. It's not like other products where people can shop around for the cheapest version. When you are in the hospital and they charge you $10 for an asperin or bandaid and you can't do anything about it - that is wrong. When the drug you need doesn't come in a generic version and you have to pay what they demand, that is wrong. I'm usually not a big fan of government involvement in my life, but I would certainly make an exception here.

    Ron, sorry to hear about your son. That is just awful.
  • When I lost my prescription coverage, I started searching for the best way to deal with the cost and found one of the free drug card sites. I'm cynical when it comes to anything being really free, so I figured it was a load of **censored** ;) But then I figured I didn't have anything to lose and took the card with me to the pharmacy. It actually dropped the cost of my fentanyl patches from $420 a month to $260. Surprised the heck out of me!

    I think it's against the rules to post the link to the site I used, but if you search "free prescription card," you should run across it. All they ask for is your first name, last name, and email address, then you can print the card out.

  • I know what you mean, insurance is getting out of control.
    I was called in a muscle relaxer the other day and i switched to a better insurance plan to get the best coverage. Alot of good that did.

    The perscription was for a musce relaxer, we all know there are many of them. But go figure it was one that no insurance covers it. I looked it up wondering why i had to pay 90.00 for 10 days worth. there was a 30.00 coupon i found online when i got back but i already filled it. And it didnt even help me a bit.

    THEN my pc doc told me not to take it with other meds im on anyway. My ortho doc called it in originally.

    well i found this article i hope it helps some in womans day magazine.
    compare prices online all pharmacies. www.EDITED.com

    apply for finacial aid some drug companies and pharmacies offer discount programs, [reading the article and writing it, not my words lol] learn more at: www.EDITED.org and www.EDITED.com

    article also says to ask your doctor if you can split certain medicines in half safely of course. your doctorbe willing to prescribe double the doseage so you can split it in half to save money and co-pays on expensive perscription. my doctor did with zoloft cause he wanted me to take name brand and also with valium name brand. 500 dollars for name brand valium and a few hundred for the zoloft when i didnt have insurance. doesnt hurt to ask.

    also ask for samples when times are hard,

    hope this helps, seen the post while i was skimming the new magazine. thought i would share.

    The sites mentioned are for mail order medications which Spine-Health does not condone.

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    Edited by moderator paulgla

  • I joined AAA; believe it or not they have a prescription discount program for ALL members, and it's the best one I've EVER used. I even had medical insurance earlier this year, with a companied paid discount card, express scripts group program, and the AAA discount beat the prices (I pay cash) by HUGE amounts. Monthly, my ER meds, breakthrough meds, anti anxiety, and muscle relaxers (generics) total 74 dollars cash with this discount. It's worth every penny of the yearly member fee.

    It wont help with Oxy ER if you don't have insurance; that's one med that you just can't get around the price on. The cost to each pharmacy for 100 20mg pills (generic) is around $200 bucks and about 400 for the 40s. Good luck everyone.

  • Oh, and the office visits.. The only way I reduced my office visit costs, was by to only see my PM every other month.

    Let your doctor/PM/Ortho know that you are strapped for cash, and, assuming you are 'stabilized', and not changing to new meds or something, ask if they can write you your next months refill so you can see them in two months instead of every month; not all docs will do it, especially if you just changed meds or are in a constantly changing situation, but it's worth a try if it works with your needs.

    This advice is mostly for cash only patients; if your co-pay is 20 bucks or something, they probably won't move on that one.
  • I put the Oxy 20mg pills, quantity 100, into the price checker for the drug card I was referring to earlier. The result for my pharmacy was:

    Generic Oxycodone HCL, 20mg, ER Tablet
    100 per bottle

    Regular price: $359.95
    Rx card price: $216.11

    The name brand name Oxycontin, with the discount, came up at $339.02 for the same dose/quantity combination.

    For the generic 40mg, 100 tablets, it was $380.51 with the Rx card.

    If that info's useful to anyone, I can PM the information on the card. They have a price checker for participating pharmacies on their website, so you can go through and determine if the card is of any value for your meds before you go to your pharmacy and give it to them. :)))
  • I got an early Christmas present yesterday. It seems that after a month of reviewing my hospital charges they decided that maybe I should have my anesthesia paid for by them. I'm still glad that on Jan. 1 I will only have to deal with them again to pay one last bill and am headed for a much better plan. One that proved in the past that they were much more efficient at processing claims than the one I have now. Too bad I won't be able to put this one behind me just yet because they still think they shouldn't have to pay the ambulance bill since they were out of network. I don't know but I was laying on the side of the road with my car totaled and I really didn't care how I got to the hospital since I was bleeding. But they thought I should have pulled out my insurance card and gave them a call to find out who should come get me. I still get a hopital bill a day and I'm wondering how on earth I'm ever going to get it all paid. I'm really grateful for some of the advice I've gotten on this post. I just wish I could get a break at least for one day from the doctor bills.
  • since i worked for myself, insurance was always scary. was on cobra after divorce and paid 650 a month.

    now i'm on ssi and medicaid and doctors don't want patients on medicaid as they don't get paid enough. one was honest enough to tell me this. also several therapists told me they have problems with medicaid.

    i'm grateful to be on medicaid/medicare at all, but it' a double-edged sword as i cannot work and stay on it.

    not that i can work now anyway as my mind has disintegrated.

    i sincerely hope that one day i'll have my mind back so i can give back help here on these boards that i have received.

    i've lost a lot of friends who tell me that i used to be so wise and helpful and now i'm the one who needs help and they've vanished. so heartbreaking.
  • since i worked for myself, insurance was always scary. was on cobra after divorce and paid 650 a month.

    now i'm on ssi and medicaid and doctors don't want patients on medicaid as they don't get paid enough. one was honest enough to tell me this. also several therapists told me they have problems with medicaid.

    i'm grateful to be on medicaid/medicare at all, but it' a double-edged sword as i cannot work and stay on it.

    not that i can work now anyway as my mind has disintegrated.

    i sincerely hope that one day i'll have my mind back so i can give back help here on these boards that i have received.

    i've lost a lot of friends who tell me that i used to be so wise and helpful and now i'm the one who needs help and they've vanished. so heartbreaking.
  • All of your stories have made this thread great. There are no cheap solutions but it is gratifying to read everybody's experiences and therapeutic to sound off about medical debt woes.
    I've been down and out all month due to worsening pain, and I only had energy to watch a mind numbing amount of tv. I'll be seeing my doc soon, and I wonder what will be next in the horizon for me.
    Again, I appreciate you sharing, and feel free to air out frustrations here.
  • I really wanted to vent somewhere about my ridiculous insurance company so I'm super glad you let us vent here. Meydey I hope your situation changes soon. I know what a pile of hospital bills feels like. It just weighs so heavy on a person and especially this time of year. I've decided to tuck them all away for this month. They can come after me in January. I refuse to let this ruin Christmas for me this year. I didn't cause this and yet I'm paying for it. I had to take out a loan on my 401K just to be able to pay all of the copays and prescriptions and PT so that I could still afford to put presents under the tree. Thanks again for letting us vent.
  • Thank you for sharing. It really makes it feel like we are all in this together. I would like to go shopping but I don't feel up to it and I have to make sure that I can keep paying for my meds and copays. We all have to make our sacrifices, don't we? All that matters is that we take care of ourselves so that we can spend quality time with family and have a good time.
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