Friday, February 27, 2009

MS Weekend

GH and I are leaving this afternoon to travel to Fort Smith, AR. We are participating in a National MS Society workshop for couples dealing with multiple sclerosis, titled "Eight Hours to Lifetime of Relationship Satisfaction." Here is a link to the info.

I think this will be fun and informative. I even convinced my parents to join us there. Although it may be a little weird if the conversations turn to more intimate matters. ;)

On an unrelated note, I am on day three of my Lenten journey to stop smoking. I have not had a cigarette since Tuesday night and I have yet to kill anyone. I have been using nicotine gum to help with the cravings, but OMG, I have been eating everything that isn't nailed down! I did OK on Wednesday, because I was fasting Catholic-style (which means one full meal, two smaller meals and no snacking in-between). But yesterday? Frightening. Please send prayers, positive thoughts, whatever you subscribe to, for me during this test of willpower.

The thing that makes it most difficult is that GH is still smoking, although I hope he will quit soon. It would make things much easier!

I will post about the seminar upon my return. Have a great weekend, faithful readers!

Peace,
Kelley

Friday, February 20, 2009

Copaxone Drama

In my early thirties, I realized that my daily life was my own personal soap opera. When I had that epiphany, I vowed to keep drama onstage and remember that I cannot control everything. Since then, I have kept a majority of drama onstage, with a few exceptions.

Somewhere at the end of January, I received my monthly call from my specialty pharmacy to schedule delivery for my Copaxone. According to my understanding, after January 1, my copay would be $150 per month, with Shared Solutions paying $50 of that, leaving me with a balance of $100. Imagine my shock when the person on the other end of the phone line told me my total would be $500+!!! I calmly told her not to ship the Copaxone and hung up the phone. Needless to say, my blood pressure skyrocketed, and I was positive my head was about to explode. Mind you, I do not have any high blood pressure problems. I advised GH of the situation, lit a cigarette to calm my shaking hands to begin the marathon telephone session to multiple entities. (Dear readers, please do not comment about my smoking vice. I know it is unhealthy and I am making plans to quit for Lent.)

First call was to my health insurance company's pharmacy line. Everyone with whom I spoke was very polite and helpful. Problem number one: the specialty pharmacy is now considered out-of-network, therefore my Copaxone would cost $150 per month copay PLUS 20% of the actual cost of the medication. WTF? When I received notification of the new specialty drug changes in November, I called the insurance company and was assured that my current pharmacy had been purchased by a larger company that was in the network. There would not be a problem. Yeah, right. The gentlman gave me the number to the larger network pharmacy and wished me luck.

Call number two went to the health insurance company proper. I informed the very nice lady that I was misled and misinformed by their representative. She kept me on the phone for about 40 minutes, trying to resolve the issue. She apologized profusely, and stated that most of the problem was with the terms my employer had negotiated with the insurance company. She wished me the best of luck.

Third call was to Shared Solutions. As always, the people there were incredibly helpful and assured me that they would take care of transferring my prescription to the new pharmacy. However, said new pharmacy was not a participant in the Shared Solutions discount program, so I would have to pay the entire $150 copay each month. Fine, just get my drugs, already! Then she said she would forward my information to Chronic Disease Fund to see if I qualified for their Copaxone Assistance program. OK, sounds like a plan to me.

I finally calmed down. GH sat there in amazement, saying he couldn't believe I had handled all of that without yelling, screaming or cursing. He usually handles these types of situations, as he is a professional buyer for a school district and negotiates very well. However, in this instance, he stepped back and let me fight this battle. Although if I got overwhelmed, he was ready to jump into the fray with teeth bared.

The next day, I received a voicemail from Chronic Disease Fund. They e-mailed the requisite paperwork; I filled it out and faxed it back to them. A few days later, I was informed that I qualified for an emergency something-or-other and they would pay up to $2500 of the cost of my Copaxone for this shipment. Awesome!

Then the new specialty pharmacy called to set up delivery. By this time, I had approximately 7 days of Copaxone left. He set up the delivery and told me I did not need to pay anything! More awesomer! (Yes, I know that's grammatically incorrect, but I like making up new words, just like Stephen Colbert's "truthiness").

I received my Copaxone last week and did the happy dance. Then I received the multitude of forms from CDF to fill out for long-term Copaxone assistance. I sent them 18 faxed pages and crossed my fingers. However, I had a sneaking suspicion that our income level was too high to be helped on a long-term basis. I was correct in this assumption. I received a letter yesterday informing me that my application had been denied. Bummer!

Honestly, I wasn't terribly disappointed. There are so many people in the MS community who truly need this assistance. GH & I are blessed with employment, insurace and otherwise good health. We are not going to bitch too much about $150 per month. The results are priceless.

A New Name for My Blog

Now that I have been in the MS blogging community for awhile, I have decided to change the name. When I first started out, I wanted this to be my journal or journey, but once I started seeing other blogs, I loved the clever, sarcastic, witty and hysterical names people had for their MS blogs. I want a cool name, too!

After seeing the phrase "compromised myelin" on Trevis's blog, I fell in love with the name and thought it would suit my ramblings quite nicely.

Coming up in the next few days, some major updates on Skelaxin and insurace copays (Bastards!).

Peace,
Kelley