Is it worth it?

By Ambra Monday, December 05, 2011

- A
- A
- A

I'm currently having a flare due to stress. Aches and fatigue. Yet here I am at work because I have to be ... why? Well aside from the obvious things like paying rent and groceries?

I work to have health insurance. Without insurance I can't afford the treatments I need to function. It's a pretty simple concept.

So why did I get so stressed out? Because my employer has decided to yet again change insurance plans. Yay for me!

They're switching us from a BCBS high deductible, which I didn't love but could handle since it covered what I needed, to a UHC plan. Currently my rheumy's office ISN'T in network with UHC. They're in the process of becoming so but I don't know how long that will take or how long of a delay in Orencia infusions I will be facing after the first of the year. Naturally, that is VERY upsetting to me since I seriously don't do well without my regular Orencia treatments.

I've also learned that I will be spending quite a bit more out of pocket everything WITH insurance on this new plan ... money that I don't have. So my husband and I are going to have to finish out our lease in our apartment and then move (again) to a cheaper place (if we can find one) in order for me to stay on my treatments, which aren't optional.

I'm very frustrated right now at how stupid and screwed up our health care system is. And I know that there are MANY people whose circumstances are far worse than mine are right now. My thoughts and prayers are with all those who need treatments and struggle every single day just to get by with a chronic illness. <3

Comments (12) | Add comment

V, Health Guide

12/ 5/11 9:32pm

I think I know somewhat how you feel, Ambra. One of my biggest fears is losing my job, or not being able to work. I carry our insurance because it is better than what my husband has available. I do have UHC, and it is really good coverage. We have three UHC plans available to us at work. I have the most expensive plan, but I'm glad that is what I had when I was Dx with RA. I do need to work for financial reasons, but the health insurance is even a more driving force. I have to have my meds, or I would be in bed all day, every day. The thought of not having meds available is a scary thing. I don't know what is going to happen with our health care system. I just keep praying that somehow the powers that be will figure something out that will work.

Blessings,

Ambra

12/ 6/11 8:04am

Thank you. I have a meeting with the insurance rep this morning so hopefully I will find out what coverage I will have exactly and how much poorer I'm going to be. I'm trying to just keep my chin up and hope for the best... what else can ya do after all? Thank you for the encouragement, I hope you have a "good" day. :)

Nana

12/ 8/11 11:49am

I too was told on my birthday that my employer was dropping coverage. We can not get cobra. I have applied for SSDI but was denied and have appealed. Called around and no one will write insurance on me. I am on Humira. Which is $2500 a month. Besides the pain I have to put up with everyday I now have the stress of this. My husband and I both work at the same company. My job is also very stressful. It was beginning to really cause stress for me then this about the insurance came about. My husband finally convinced them to keep it and we would pay it. This is going to be hard because it is not cheap. Finally, with all the stress I kept having RA flares and finally just had to quit work. I am hoping this will help me get SSDI sooner. Please help pray that it will. I just can not go back to that stressful job.

I hope everything works out for you.

God bless,

Nanamom

Ambra

12/ 8/11 12:20pm

I'm so sorry to hear that!! It might not be an option for you, I don't know much about Humira but pharmaceutical companies sometimes have assistance programs to help you afford you medications even WITH insurance. I just found out that I will be getting an Orencia co-pay card. They give you up to $8000 a year to pay for the cost of the medication itself, and I pay a $5 co pay every time I fill the Rx. Something you might check into. It is going to be a financial life saver for me!

V, Health Guide

12/ 8/11 9:35pm

I will be praying for you and your family, Nana. Try to take just one day at a time.

Hugs,

Nana

12/ 8/11 11:07pm

Thank you V

Lene Andersen, Health Guide

12/ 9/11 3:30pm

this is one of those topics where I have very little to offer because I live in Canada. And maybe I'm naïve, but I simply don't understand the part where you have to delay your treatment and with your help in jeopardy because of what amounts to administrative issues. It's not like you're starting a new medication, but you've been on this for a while and yet, for matters that have nothing to do with you or your treatment, you're up against a wall. Can your doctor help you with information about places that can maybe offer bridging treatments?

I just thought of something… Up here in Canada, Abbott (the makers of Humira) will bridge your treatment if there is a holdup with continuing funding. You may want to contact Orencia and explain your situation - they might have a bridging program that can help you. As well, there are places that can help with your co-pays - check out Lisa's post about financial assistance programs for medications. included in that article is contact information for Orencia - they offer copayment assistance and assistance if you are un- or underinsured. There are also other places that can help you with co-pays.

Ambra

12/ 9/11 4:02pm

Hopefully I won't have to face too much of a gap. They're going to give me an Orencia co-pay card and an Rx for the self injectible when I go in for my last infusion Dec 19th. Then as soon as I get my new insurance card they will get it pre-certified with the insurance company and I should be good to go after that. HOPEFULLY!

Nana

12/ 9/11 4:41pm

Nana

12/ 9/11 4:43pm

I also have a co pay from the company of Humira that is $5.00. If or when the insurance company decides it does not want to pay anymore for the Humira, which they pay $1900 each month, then I will try a website I was told about. www.needymeds.org. Good luck to you all.

Nanamom and Merry Christmas

Lene Andersen, Health Guide

12/ 9/11 6:23pm

keeping my fingers crossed! Let us know how things go, please?

V, Health Guide

12/ 9/11 9:52pm

Nana,

I have a friend who takes Humira and she had to quit her job. She just couldn't do it anymore. She has applied for disability. She contacted Humira, and they are going to send her Humira free of charge for a year.....worth a try?

Is it worth it?

Ask a Question