Rheumatoid Arthritis Support Group

Rheumatoid arthritis is a chronic, inflammatory, multisystem, autoimmune disorder. It is a disabling and painful condition which can lead to substantial loss of mobility due to pain and joint destruction. The disease is also systemic in that it often also affects many extra-articular tissues throughout the body including the skin, blood vessels, heart, lungs, and...

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nonightshades 12/01/2015

Yes the drugs we take do ratchet up the anxiety. I'm just not real trusting of insurance not changing things mid stream or producing a "cap" out of nowhere. So, each month before ordering Humira from the specialty pharmacy I call and get my balance due first. I mean if it's three months worth of orders before I catch a problem (call BC/BS every other month, change is coming 2/1/16) then I'm on the hook to the spec pharm over ten grand.

I've noticed the pattern goes like this: pop myself with the second pen of the month's prescription (2/mo) and think "I've got to call next week and order the next round"; that's when the anxiety begins to build and build and build. The stuff works and I really don't care to have to deal with the pain again unless necessary. Then I make the call, get the accounting folks on the line as I did just now, "Mister ____ I see that you have a credit on your account". YEAH! Anxiety over........until the next time to order.

What stupidity. I know the anxiety is all in my head. I know I can handle the crap (RA) decently without the biologic. Just really ticks me off that thanks to our ridiculous medical/payment systems that any of us must go through it.

The six inches between our ears, most important real estate in the world...I must maintain control of it.

51percent 12/01/2015

I know exactly how you feel. I used to have United Health Care and they try so hard not to pay claims...amazing. So when I got Medicare, I got BC/BS for my supplement on the recommendation of my insurance agent. He said they have the best claims payment record and if there is a depute, they solve it rapidly. And having gone to them through an insurance agent(independent) I can call him and have him call BC/BS and do the dirty work for me.

BTW, in case anyone is wondering, I didn't pay the insurance guy a cent....he gets paid by BC/BS.

We do get emotionally addicted to our biologics and get anxious about making sure we can have our drugs. I'm definitely an Orencia addict. I start to get anxious that everything has been paid about a week before the next infusion is due...just like an addict. Only cure? Having insurance that you know is doing it's job. Made it much easier than when I had UHC.

gentle hugs..............Jen

altoclef 12/01/2015

It's a shame that the drugs we rely on so we can get out of chair are also capable of sending us to the poorhouse. It's not stupidity, Nightshades, it's self-preservation to check every single time.

Sunvalleygal 12/02/2015

I may not be understanding your post completely, but has your doctor not told you about Humira protection plan? It's not hard to quantify for. It costs me $5 a month for my shots and also helps pay for one dmard. Your doctor should have this information. Or you can Google it. It's by Abbvie.
Humira Protection Plan....

Sunvalleygal 12/02/2015

https://m.humiracomplete.com/cost-and-copay

2leftfeet 12/02/2015

I agree with what Sunny said. The first 5 biologics I was on had assistance programs, that I never paid more than $5 per month - Enbrel, Humera, Orencia, Cemzia, and Actemra. All had the same plan, $5 per month for self injecting, You do need to be on a private insurance, such as through you or your employers insurance. I do not think it works if you are on some sort of government assistance, or if you are on medicare.

2leftfeet 12/02/2015

rereading* insurance you have through you or your spouse employer.

nonightshades 12/03/2015

Yes I have sunvalley, know all about it. As 51% mentions the emotional addition of the biologics that is part of what drives me to check and worry. I think we've all heard of the heroine model....get the individual hooked on it by letting them have it cheap then BAM, jump the price. In our case from $5/mo to $3500+/mo (insurance price is 3100+). When the RA Dr. prescribed it he brought in the Humira assist card and insisted that I call. I did call, all prepared with tax/income information for the past 5 years ready and expecting to be turned down because of income being too high. Got them on the phone, they asked for prescribing Dr's name/info, asked for my home address and about 10 seconds after I gave my zip code (Southeast Alabama) the person on the phone said something like "Alabama, oh yes, you qualify". Well, that made the red flags go up for me mentally and I began thinking about the heroine thing.

Strange disease that we have with strange medicines as well.

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