it’s getting harder and harder to breathe
Oct. 13th, 2011 07:07 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
dragonlady7So I had an asthma attack yesterday. It sucked. It was the first real asthma attack I’d had since 1984. No obvious triggers, but it sucked. I had been prescribed a maintenance, steroid inhaler to improve my overall lung strength, and a rescue inhaler to take as needed in case of acute episodes, and I’d been given a sample of the maintenance inhaler to see me through.
I found out that neither was covered by my insurance; my insurance only covers generic prescriptions, and if no generic is available, I must pay full price for the name-brand item. I assumed it was just those particular ones, so I intended to call the doctor to get them switched, but of course, I forgot. I improved dramatically on the sample inhaler, but then ran out, and life got hectic. Until yesterday, when it became apparent I really did need to go back on the prescribed medicine.
I went and spoke to the doctor, who wrote as generic a prescription as he could manage. Last night the pharmacy called; it wasn’t covered. They said they’d talk to my doctor today. So tonight I got a call from a nurse at my practice.
There are no steroidal maintenance inhalers available in a generic. The cheapest one they can find me is still nearly $300 a month, and is not covered by my insurance. There are also no rescue inhalers that are generic. The cheapest they can find me is not covered, and will cost me about $60.
I earn about $400 a month, net. (Gross is higher, but of course, taxes, and then my insurance, all have to get taken out. Of course. I pay, for the record, about $20/week for my insurance. It ain’t cheap.)
The doctor’s office scrambled around to find me some samples to get me through so I won’t die imminently, and I’ll call my insurance company to see what the hell their policy would have me do, and I’ll call the drug manufacturer and see if they’ll give me any kind of discount, and I’ll look into buying it cheap from Canada or something.
But I guess I’m just to the point where I’m wondering how this is even legal. How can this company decide what’s too expensive to cover, despite what my doctor thinks? It’s not even like I have a rare condition– I hear about those things and I think, that ain’t right, but then I think, well, you know, it is rare and the treatment’s experimental, maybe the insurance company’s numbers just weren’t factored for something like, well, OK, it’s still bullshit, but it makes sense in a The Cold Equations, sci fi scenario, only one of us can survive kind of way (is that story obscure or did I make that up?). But this?
It’s asthma. Everyone and their mother has asthma. Seriously half the people I know have asthma. And these are not extreme treatments; these are the most basic things they do for people with this incredibly common condition. How can this private company sell me insurance that then doesn’t cover the incredibly common treatment for an incredibly common condition? In what world is that all right to have be legal?
So I’m grumpy tonight, as well as wheezy.
I found out that neither was covered by my insurance; my insurance only covers generic prescriptions, and if no generic is available, I must pay full price for the name-brand item. I assumed it was just those particular ones, so I intended to call the doctor to get them switched, but of course, I forgot. I improved dramatically on the sample inhaler, but then ran out, and life got hectic. Until yesterday, when it became apparent I really did need to go back on the prescribed medicine.
I went and spoke to the doctor, who wrote as generic a prescription as he could manage. Last night the pharmacy called; it wasn’t covered. They said they’d talk to my doctor today. So tonight I got a call from a nurse at my practice.
There are no steroidal maintenance inhalers available in a generic. The cheapest one they can find me is still nearly $300 a month, and is not covered by my insurance. There are also no rescue inhalers that are generic. The cheapest they can find me is not covered, and will cost me about $60.
I earn about $400 a month, net. (Gross is higher, but of course, taxes, and then my insurance, all have to get taken out. Of course. I pay, for the record, about $20/week for my insurance. It ain’t cheap.)
The doctor’s office scrambled around to find me some samples to get me through so I won’t die imminently, and I’ll call my insurance company to see what the hell their policy would have me do, and I’ll call the drug manufacturer and see if they’ll give me any kind of discount, and I’ll look into buying it cheap from Canada or something.
But I guess I’m just to the point where I’m wondering how this is even legal. How can this company decide what’s too expensive to cover, despite what my doctor thinks? It’s not even like I have a rare condition– I hear about those things and I think, that ain’t right, but then I think, well, you know, it is rare and the treatment’s experimental, maybe the insurance company’s numbers just weren’t factored for something like, well, OK, it’s still bullshit, but it makes sense in a The Cold Equations, sci fi scenario, only one of us can survive kind of way (is that story obscure or did I make that up?). But this?
It’s asthma. Everyone and their mother has asthma. Seriously half the people I know have asthma. And these are not extreme treatments; these are the most basic things they do for people with this incredibly common condition. How can this private company sell me insurance that then doesn’t cover the incredibly common treatment for an incredibly common condition? In what world is that all right to have be legal?
So I’m grumpy tonight, as well as wheezy.
