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|-+  The Psychological side of Disability
| |-+  The Comfort Zone
| | |-+  Hospital nightmare
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Topic: Hospital nightmare  (Read 1342 times)
TraceyJuliet
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« Reply #15 on: February 15, 2017, 09:23:03 PM »

The manufacturer may have a patient assistance program or discount.

"Come unto me, all ye that labour and are heavy laden, and I will give you rest.

 Take my yoke upon you, and learn of me; for I am meek and lowly in heart: and ye shall find rest unto your souls.

 For my yoke is easy, and my burden is light"

Matthew 11:28-30

(((((( JM ))))))
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I survived the 80's, drug rehab, twins, and divorce. None of those things were as stressful as the disability process.
Name: Tracey
Location: Naperville, Illinois
Age at Application: 51
Disability: F31.32 Moderate Bipolar 1 Disorder, PTSD, OCD, ADD, Anxiety
Date Applied: 9/22/2014
First Approval/Denial Date: Denied: 2/06/2015
Reconsideration Approval/Denial Date: Reconsideration Denied 4/18/2015
Date OTR requested: Hired Attorney 5/13/2015
Date Hearing Notice Received: 9/2/2016
Hearing Date: 11/28/2016
ALJ Approval/Denial Date: 12/23/2016 Fully Favorable, thank God!!!
Date Award Letter Received: 01/10/2017
TraceyJuliet
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« Reply #16 on: February 15, 2017, 09:40:06 PM »

Tracey,

I take a small amount of abilify (half of a 2mg pill). I'm finally starting to run out of abilify later this year. I had a small stockpile from when I had drug coverage through my employer and then medicaid and since I only take half the smallest dose, I always got twice what I needed. (Medicaid covered generic abilify for me 100%.)

Regarding the cost of abilify, in case for some strange reason your insurance doesn't approve it, please check goodrx for generic abilify prices in your area. In my suburb, Target is about $113/month for my small dose, but it goes up $146/month depending on dosage.

Anyways, I just saw my psychiatrist yesterday and she faxed a new abilify prescription (for the generic) to rxoutreach because I had set up an account with them after she told me about them. She has many of her lower income patients using it. It's a US pharmacy for low income patients. You have to set up an online account yourself, then wait awhile and have your doctor fax them your prescription(s). And they only have certain drugs. I don't know if any of your doctors are familiar with the program or would be willing to use it, but it's hopefully how I'll be getting my abilify going forward.

It's $35/month for my dose of abilify ($40/month for higher doses).

Dawn - my goodness that's a heck of a lot cheaper than $954! I went to the GoodRX site, found it myself, and saw that Target looks to have the cheapest cost. Heck, even when it finally IS ready for pick up at Walgreens, now I probably can't even purchase it. I had no idea what I was getting myself into. I'm researching drug assistance programs. I'm not going to let this mess with my recovery and quality of life
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I survived the 80's, drug rehab, twins, and divorce. None of those things were as stressful as the disability process.
Name: Tracey
Location: Naperville, Illinois
Age at Application: 51
Disability: F31.32 Moderate Bipolar 1 Disorder, PTSD, OCD, ADD, Anxiety
Date Applied: 9/22/2014
First Approval/Denial Date: Denied: 2/06/2015
Reconsideration Approval/Denial Date: Reconsideration Denied 4/18/2015
Date OTR requested: Hired Attorney 5/13/2015
Date Hearing Notice Received: 9/2/2016
Hearing Date: 11/28/2016
ALJ Approval/Denial Date: 12/23/2016 Fully Favorable, thank God!!!
Date Award Letter Received: 01/10/2017
Lit Love
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« Reply #17 on: February 15, 2017, 10:09:44 PM »

Excellent resource at rxoutreach.org newdawn !!!

TJ you should qualify income wise.  Check it out if you haven't already.
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« Last Edit: February 15, 2017, 10:15:52 PM by newdawn »
newdawn
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« Reply #18 on: February 15, 2017, 10:14:45 PM »

When I was on medicaid, I was able to get generic abilify at my usual pharmacy for free because medicaid was really good about covering generic medications. My psychiatrist may have had to send in a prior authorization when the pharmacy contacted her but she's used to that. It's not just medicaid and medicare that require prior auths. The drug coverage I had with my employer required them too for certain things.
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Name: Dawn
Location: IL
Age at Application: 31
Disability: Depression, anxiety
Date Applied: 11/2013
First Approval/Denial Date: 03/2014
Reconsideration Approval/Denial Date: 11/2014
Hearing Date: 11/13/2015 (Friday the 13th!)
ALJ Approval/Denial Date: 01/15/2016 Fully Favorable (rec'd 01/21)
Date Award Letter Received: 02/17/2016 (rec'd 02/20)
Date Back Pay Received: 02/13/2016 (paper check)
Additional Info: 02/09/16 mySSA account updated with approval info. 02/22 rec'd medicare card in mail. Hired lawyer after reconsideration denial. Requested an in-person hearing.
Salvette
SSDFacts VIP
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« Reply #19 on: February 16, 2017, 07:15:45 AM »

I would like to add my 2 cents re: the cost/copay assistance, etc, I am on a Medicare adv. Plan, and realized last year that most of my copays for meds were MUCH higher than if I had no insurance, esp. When I went back on generic Cymbalta, with my insurance my co pay would have been over $60 a month, so I asked my local pharmacy how much would it be without insurance...only $20!! Now this is an independent pharmacy I've been using for 15 years, although they just run u it thru the insurance, I feel they should be a little more consumer driven.  SO, yes $900+ is ridiculous, and all that extra "copay" only goes back in the insurance company pocket. Always ask for the cash price, and if they give you a hard time, go elsewhere!
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Salvette
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« Reply #20 on: February 16, 2017, 07:26:26 AM »

Even if Walgreen already ran it thru your insurance, they can easily undo it, but you have to tell them you want to pay cash, it just makes no sense to treat consumers so unethically!
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Lit Love
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« Reply #21 on: February 16, 2017, 09:27:57 AM »

The generic cost of Abilify is roughly 10 percent of the branded drug at Costco. 

TJ, maybe you need to check with your doc and see if the generic is ok.
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newdawn
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« Reply #22 on: February 16, 2017, 10:45:38 AM »

I would like to add my 2 cents re: the cost/copay assistance, etc, I am on a Medicare adv. Plan, and realized last year that most of my copays for meds were MUCH higher than if I had no insurance, esp.

I discovered something similar when I went on Medicare Part D. It's best for me to pick the Part D plan that is overall cheapest for everything except generic abilify and just pay for generic abilify on my own.

(Sorry to somewhat derail your thread Tracey.)
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Name: Dawn
Location: IL
Age at Application: 31
Disability: Depression, anxiety
Date Applied: 11/2013
First Approval/Denial Date: 03/2014
Reconsideration Approval/Denial Date: 11/2014
Hearing Date: 11/13/2015 (Friday the 13th!)
ALJ Approval/Denial Date: 01/15/2016 Fully Favorable (rec'd 01/21)
Date Award Letter Received: 02/17/2016 (rec'd 02/20)
Date Back Pay Received: 02/13/2016 (paper check)
Additional Info: 02/09/16 mySSA account updated with approval info. 02/22 rec'd medicare card in mail. Hired lawyer after reconsideration denial. Requested an in-person hearing.
Salvette
SSDFacts VIP
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Posts: 434


« Reply #23 on: February 16, 2017, 11:48:39 AM »

Unfortunately I'm limited with advantage plans, the one I could pick that is a ppo type, includes the part d, so when they do, you cannot opt for a separate plan.
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TipBill
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« Reply #24 on: April 06, 2017, 06:17:22 PM »

Hi Tracy,

I too live in Illinois.  Sorry I don't remember all the details but several years ago my doctor put me on Abilify. Like you said it was very expensive but if I remember correctly I got some kind of card from my doctor that allowed me to get the medication for $20.00 a month.  So I would ask your doctor about that.  Also have you ever heard or AstraSeneca?  I have seen commercials for it stating if you need help paying for your medication they may be able to help.  I don't have any personal experience with them, just heard their commercials.
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Name: TipBill
Location: Illinois
Age at Application: 59
Disability: Degenerative Disc Disorder, Chronic Sleep Apnea, Spinal Stenposis. Anxiety Disorder, Panic Disorder, Depression, PTSD
Date Applied: May 2014
First Approval/Denial Date: Octobet 2014
Reconsideration Approval/Denial Date: April 2015
Date Hearing Notice Received: August 2016
Hearing Date: November 10, 2016
ALJ Approval/Denial Date: March 2017 (after changing my on set date from May 2014 to July 2015)
Date Award Letter Received: March 21, 2017
Date Back Pay Received: March 15, 2017
Helper
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« Reply #25 on: April 06, 2017, 07:17:07 PM »

Hi Tracy,

I too live in Illinois.  Sorry I don't remember all the details but several years ago my doctor put me on Abilify. Like you said it was very expensive but if I remember correctly I got some kind of card from my doctor that allowed me to get the medication for $20.00 a month.  So I would ask your doctor about that.  Also have you ever heard or AstraSeneca?  I have seen commercials for it stating if you need help paying for your medication they may be able to help.  I don't have any personal experience with them, just heard their commercials.

AstraZeneca is a drug company that makes medications & has a patient assistance program for the medications they make.
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Age at Application: 26 age of onset (but I did not apply until 28)
Date Applied: August 2011
First Approval/Denial Date: November 2011
Additional Info: I was fortunate to be approved on my initial application due to extensive medical records (12+ doctors) & documentation of unsuccessful work attempts even with significant accommodations
newdawn
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« Reply #26 on: April 06, 2017, 07:30:46 PM »

Luckily, Tracey's insurance ended up covering the abilify!
Here's where she posted about it: http://ssdfacts.com/forum/index.php/topic,21941.0.html
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Name: Dawn
Location: IL
Age at Application: 31
Disability: Depression, anxiety
Date Applied: 11/2013
First Approval/Denial Date: 03/2014
Reconsideration Approval/Denial Date: 11/2014
Hearing Date: 11/13/2015 (Friday the 13th!)
ALJ Approval/Denial Date: 01/15/2016 Fully Favorable (rec'd 01/21)
Date Award Letter Received: 02/17/2016 (rec'd 02/20)
Date Back Pay Received: 02/13/2016 (paper check)
Additional Info: 02/09/16 mySSA account updated with approval info. 02/22 rec'd medicare card in mail. Hired lawyer after reconsideration denial. Requested an in-person hearing.
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