It’s about time I have another fight with my medical insurance company, Athem Blue Cross Blue Shield. I received a letter from them at the end of December letting me know that my plan is no longer covering omeprazole (the generic of Prilosec) in 40mg doses. I am taking the 20mg pills but had my doctor spend weeks getting them to authorize a quantity of two a day, bringing the total dose to 40mg.
I called Anthem today, finally, to discuss this change in my coverage and how it’ll affect me. Using their handy [sarcasm – it sucks] drug coverage & pricing tool online, I won’t be covered. Previous experience has shown me that this tool doesn’t take into account authorizations on file and relatively has a mind of its own. It’s useless. Anyway, I got a very pleasant customer service representative to understand my dilema.
Nexium works the best for me, but it costs $65 a month or more. I’ve tried EVERYTHING else and nothing works except Prilosec or its generic in a higher dose. Prilosec is chemically similar to Nexium and actually contains about 20% of the active material of Nexium. Fun fact for the day.
The CS rep took the time to talk with a pharmacy specialist, placing me on hold for a good ten minutes. She said that because my doctor has completed the prior authorization form and they approved it, they’ll cover the prescription. My renewal for the pills comes up at the end of the month, so I’m crossing my fingers I won’t have WWIII to contend with. In the end, I could ask my doctor for 90 days of samples, but since I have insurance I might as well make them pay for it.
Continue reading Anthem, How I Dislike Thee
I’m happy to say that I’m done with school for this semester and got an A in both of the classes. The software engineering class was difficult and took a lot of time so I’m glad it was recognized with a good grade. Next semester I’m taking a project management course and something with IT management over the Internet. Going to school one night a week will be nice.
The holidays are nearly over and I can’t believe another year is starting. Next year I’ll be turning 30, will have been together with Tazz for 13 years, had our house for 8 years, been diagnosed with migraines for 7 years. I have typically established goals for myself in writing on this blog, but never really think about them in such a concrete manner again throughout the year. To sum up this next year’s goals: be healthy & be happy. Making a punchlist of dos and don’ts isn’t productive, for me at least. As long as the choices I make maintain my health and happiness, I’m cool with that.
I’ve had a rash of migraines over the past month that hopefully I can just attribute to stress. In the past, I would easily have 5-6 episodes a week that would respond to over the counter medication. However, now I seem to get more frequent spikes of pain that last a few minutes and then go away for most of the day. Taking any medication doesn’t make sense in these cases as the pain will probably subside before the medication has a chance to be absorbed into my system. The number of instances of migraines that visibly affect my speech or thought processes are also on the rise. I don’t normally get overwhelmed with pain to the point where I can’t think straight but at least once in this month I’ve had a migraine that made me feel drunk or like I was stroking out.
Next year my employer’s medical insurance is changing its deductible schedule for physician visits. My family doctor will increase to $25 a visit and now specialty visits, like to my neurologist, will be increased to $50. I may see if my family doctor can get my records from my neuro to help with managing the migraines. I usually only see my neuro once a year but $50 is quite a bit of money to be given the next round of antiseizure medications that help the migraines but put the rest of my body through hell. I’m sure everybody is going through this same type of change with their benefits, assuming you even have a job during this next year.
Happy New Year everyone. Lets hope it brings more balance to our lives and a renewed sense of hope.
I’ve decided to make some mid-year resolutions. We always forget about what we’ve promised ourselves to do and I need to reaffirm what my goals are. I’m also keeping them simple because the more lofty the goals it seems the easier it is to quit trying to reach them. Incremental movement 🙂
- Improve my diet. This means eating my fruits & vegetables, cooking at home with recipes and fresh ingredients. Reduce or eliminate sodas (sugared and diet) and eliminate dependence on caffeine.
- Exercise on a regular schedule. We’ve been walking a couple nights a week but I need to follow this up with some Wii Fit time or general Yoga stretching before work in the morning.
- Get rid of the junk around me. I need to take all the crap we have packed away in the house and donate it to a resale shop or recycle it if it’s really junk. Collecting “stuff” I think adds to suck up positive energy.
- Finish school. I still have two years left of school and I am still on track for graduation. I don’t expect myself to stop going but it is one of my goals that I need to keep on the radar.
Losing weight and eliminating the dependence on hypertension medications is the higher-level goal for the diet and exercise. Eliminating the junk will help with finishing projects and keeping myself motivated to improve my surroundings. School is just one of those things that I think I’ll forever be attending. I mean that in a manner of even after I get my master’s degree, I want to go back and teach.
I’ve noticed a trend in both family and friends. The more you are honest about how you are feeling and discussing your ailments, the less people care about them. It’s almost a paradox – the people you love are supposed to help you through things like pain, sickness, etc. However, they can be easily overburdened by your chronic syndromes.
My stomach has been pretty wonky since I was 19. I started taking Pepcid when it first came out on the market and it helped for a while. It eventually stopped working and I had to make my way up to proton pump inhibitors. Nexium seems to be “the one” that just works. Unfortunately, my new employer/insurance doesn’t cover the purple pill. Protonix just came out with a generic but it’s not the best. So, the GERD and hiatal hernia have been ruining my life. Drinking hot tea helps calm it down but ultimately my weight (which is going down) and drinking soda are the primary factors.
I’m babbling. My point is, it’s a fine line you have to walk/balance on to keep your family from being numb. I think we too easily forget we can suck it up for a while, if we’re actively trying to prevent accessing migraine triggers, bad foods for our heads and stomachs, etc. Part of me says screw off, if you don’t like it then you can kiss my ass. The other part of me says that it’s hard enough for me going through it and I should use my external help wisely.
Part of the other issue that I’ve discussed before is both the migraines and GERD are internal things. A little red light doesn’t start blinking on your forehead to confirm you’re ill. (Although, I think sometimes we see blinking lights as an aura.) You know people, even your close friends, do think you’re either overreacting or acting in general if you get symptoms frequently.
Do I show the pain, or just mask it with a smile?
I finally went back to my doctor and talked to him about the current medications I am on. I’ve been trying to lose weight over the years and even the modest amount of activity fails to show results. Reading up on beta blockers (I’m on Toprol XL) I found out that because they keep your heart rate low, it can interfere with aerobic exercise. Not getting above a certain bpm prevents my body from burning the fat like it should. Funny huh – I’m on beta blockers because I have high blood pressure and the best way to drop that is to lose weight. Can’t lose weight if the meds prevent it…
Tazz and I also went camping two weeks ago and it was a lot of fun. The weather was decent and the headaches kept themselves to a minimum. We’ve already planned another weekend trip in July and September, camping in local areas. I found that being away from technology and being active kept my mind off of the headaches. Sometimes I wonder if they’re self-induced anyway!
I started this post early this morning and am now finishing it up before I leave from work. Since I left during lunch to take a walk around downtown, I’ve had a wicked headache. Caffeine, Ibuprofen, and now Naproxen isn’t even touching it. I’m thankful that I’m leaving work soon because this one is kicking my ass right now.