Healthcare blows the budget:(

**littlemotherhaywood** · 01-24-2007, 11:30 AM

I know it's nothing compared to some I've seen on here, but we just can't get a break. My dh suffers from severe migraines (we've narrowed down several triggers over the last almost decade and eliminated them as we discover them) and all of a sudden, his frequency has gone from a few a month to a few a week. He was put on a new medication and the insurance would only cover six. The script was for twenty. He paid the copay of $40 (went up) for the six and then contacted the insurance. With a call from the doctor they agreed to cover the remainder of the script, but now the pharmacy says there's a second copay. That just boggles me. I know they already processed it like it was a script for six, but they did that before they even told him that's all the insurance would cover.

On top of that dd has strep. $35 between script and appt copays. I'm just thankful we have healthcare to take care of this stuff.

Now I have a sore throat and ds has a fever today. Potentially another $70 if we end up at the doctor with the same thing as dd. Plus, I can't work tomorrow because AJ has to be fever free for 24 hours before I work so another $36 lost in wages.

It just all adds up fast doesn't it.

**FrugalMomof3** · 01-24-2007, 11:44 AM

Kim I am soooo sorry this is happening to you, I just say be thankful for insurance as I have none for myself so if I get sick I pay full price

I hope your family gets well soon, it's the stinky weather, one day nice one day cold. Keep your head up!

**littlemotherhaywood** · 01-24-2007, 11:47 AM

Thanks Tracy. I am soooo grateful for the insurance. Kayla's appointment alone yesterday was $140 and she has a regular script that runs $200 a month. No way could we afford that and we're over the income limits for most types of assistance when it comes to healthcare.

**ewokgirl** · 01-24-2007, 03:44 PM

I can totally relate on the migraine thing. My old insurance allowed me 18 Imitrex pills a month. Current insurance allows only 9. If he finds himself running low or out, ask the doctor if he/she has any samples. I've done this numerous times over the years. My neurologist's office is always so helpful about giving me what they have.

I highly recommend a wonderful book called Heal Your Headache: The 1-2-3 Program for Taking Charge of Your Pain by Dr. David Buchholz. This book changed my life! I used to have 4-6 migraines per week. My neuologist put me on all sorts of preventives, but they never worked, and they had HORRIBLE side effects. My mom's best friend recommended this book, and I was finally ready to try it. It's a tough program, but it literally changed my life! I got down to about 2 migraines a month!

Now, things have actually been bad again the past few months, but my migraines ramped up again after a visit to the chiropractor for excruciating back pain. The two may not be related, but it seems more than coincidental that the migraines returned right after that adjustment.

I'm finally back to not having so many. In fact, I had my period last week, and I didn't even have menstrual migraines! I have a drug called Frova I can take all during my period to stave off the migraines, but even with insurance, it costs me $67 for 9 pills. Too expensive.

I'm now trying the 3-month mail order option for my drugs. It's going to save me about $100 for Imitrex, Frova, and Darvocet.

Out of curiosity, does your hubby have a lesser drug he can take when he's out of the good pills? I can get generic Darvocet for less than $10, and my neurologist writes the script for 60 pills/month. It's nowhere near as good as Imitrex, but I've learned that it'll do in a pinch (at least it lessens the pain), and if my migraine is weather-related, if I take a Darvocet with Benadryl, it'll totally take care of the pain.

Does your hubby think his recent bout with more migraines is stress related?

**bevjean** · 01-24-2007, 04:51 PM

I guess I'm lucky that I have insurance, but the policy we have isn't very reassuring. Yesterday I paid a $50 co-pay for a bottle of cough medicine and a $30 co-pay for an antibiotic. I almost had a heart attack when they told me how much I had to pay for a stupid bottle of cough medicine. My hubby's job switched plans this year. The old plan was horrible and this new one is much worse. Last year I was paying $3.76 for one of my meds and when I went in this month it had jumped up to $11.99. While that still isn't a lot of money for prescription meds, I thought it was ridiculous to have tripled. I dread going in to have my more expensive meds refilled.

**Neeley** · 01-24-2007, 05:31 PM

I hope you all get to feeling better soon. Medical does add up quickly. We have great medical coverage and DH has $5k annually put into a Flex Spending Account at work to reimburse us for out of pocket expenses (OTC meds, Doc co-pays and all of my prescriptions are non generic so insurance only pays 80% - Flex reimburses us the other 20%). With that said, our prescription plan is a point of sale and we pay up front for all meds and then insurance direct deposits the reimbursement in our checking account(usually within a week). I have monthly prescriptions that run a little over $900, so the first month it was a shock to the budget. I am so glad between insurance and Flex we get it all back though - it could be worse.
Again, I hope you all get to feeling better, maybe you won't have to make anymore doc visits for a while.

**ewokgirl** · 01-24-2007, 05:54 PM

I hear you, BevJean! I use a prescription toothpaste before bed each night. Last year I paid only $4 for it. When I refilled it last week, it had jumped to $14! Thankfully, it lasts a long time...

**Luv2BeFrugal** · 01-24-2007, 05:58 PM

I know what you mean. I've been having ear problems and I had to go to the doctor yesterday and get it checked. $190 later (NO insurance) he says my ear will be fine...that my problem is with my sinuses and will requre surgery...at least he said it could wait until we get insurance (someday!). Erf.

Sorry you're going thru this...I hope your family gets well soon!! Be thankful for the insurance...I can't wait until we can get some...

**littlemotherhaywood** · 01-24-2007, 06:55 PM

Originally Posted by ewokgirl

I can totally relate on the migraine thing. My old insurance allowed me 18 Imitrex pills a month. Current insurance allows only 9. If he finds himself running low or out, ask the doctor if he/she has any samples. I've done this numerous times over the years. My neurologist's office is always so helpful about giving me what they have.

I highly recommend a wonderful book called Heal Your Headache: The 1-2-3 Program for Taking Charge of Your Pain by Dr. David Buchholz. This book changed my life! I used to have 4-6 migraines per week. My neuologist put me on all sorts of preventives, but they never worked, and they had HORRIBLE side effects. My mom's best friend recommended this book, and I was finally ready to try it. It's a tough program, but it literally changed my life! I got down to about 2 migraines a month!

Now, things have actually been bad again the past few months, but my migraines ramped up again after a visit to the chiropractor for excruciating back pain. The two may not be related, but it seems more than coincidental that the migraines returned right after that adjustment.

I'm finally back to not having so many. In fact, I had my period last week, and I didn't even have menstrual migraines! I have a drug called Frova I can take all during my period to stave off the migraines, but even with insurance, it costs me $67 for 9 pills. Too expensive.

I'm now trying the 3-month mail order option for my drugs. It's going to save me about $100 for Imitrex, Frova, and Darvocet.

Out of curiosity, does your hubby have a lesser drug he can take when he's out of the good pills? I can get generic Darvocet for less than $10, and my neurologist writes the script for 60 pills/month. It's nowhere near as good as Imitrex, but I've learned that it'll do in a pinch (at least it lessens the pain), and if my migraine is weather-related, if I take a Darvocet with Benadryl, it'll totally take care of the pain.

Does your hubby think his recent bout with more migraines is stress related?

I think anything could be potentially stress related but we are the most stress free we've been in about a decade. There's always something to stress about but for now things are going as well as can be expected.

I know he was on preventatives years ago (the beta blockers) but they didn't work then and the new doc just dismissed the idea when he asked about them. So far he's tried Imitrex, Zomig, and Maxalt at the highest dosages allowed. He did get some extras from the doctor when he ran out. The newest one (which doesn't seem to be working) is Axert. He sees a neurologist in three weeks. I'm hoping they can do something for him. When he saw a chiropractor a few years ago he got headaches with almost every adjustment. I'll see if I can find that book for him. We're making a lot of health changes and I think he's ready.

As far as everyone else now AJ woke up with a temp of 101.3 and complained about his head and his mouth hurting. I gave him some motrin and he seems okay. I called to see if the doctor could fit us in, but it was too late. We go first thing in the morning. They recommended the urgent care clinic but our copay is $100. I'm just going to do what I can to keep him comfortable until tomorrow. As long as he's eating and drinking and keeping his temp down, I think he'll be fine. I'm just kicking myself for not calling this morning when he woke up with a fever.

**ewokgirl** · 01-24-2007, 07:06 PM

The preventives my neurologist kept putting me on were either anti-depressants or anti-seizures. They all had bad side effects, but the anti-seizures were the worst. One (Topomax) had several bad effects, but the worst was that it made me paranoid. I was convinced people were talking about me wherever I went. Totally freaked me out!

Axert was worthless for me. Maxalt was okay, but the taste was awful (melt under the tongue). Don't remember if I tried Zomig. I always wind up back with Imitrex. It works better than anything else I've ever tried.

I was really surprised when I used that book and learned some of my triggers. Hard cheeses, pineapple, blueberries, chocolate. Oh, and weather changes, not enough or too much sleep, stress, extreme temperature changes (like in summer here going from 100+ outside to over-air conditioned buildings), bright lights... It's a pretty long list. *sigh*

I'm sorry your kiddo is sick, too. But I agree with you that he probably doesn't need to go to urgent care if he's eating and drinking. Hope he feels better soon!

**claimsgirl66** · 01-24-2007, 08:10 PM

I am new to the boards, but nice to know I am not alone. I too am prone to migraines and have tried to manage them with avoiding certain triggers. Certain perfumes knock me right out. I was having a little pity party for myself this month too for the out of pocket medicals I have had-$300 for some dental work that includes the new annual deductible, a new $400 annual health insurance deductible and then I had some of my allergy medicines refilled. ( another $30), I am grateful I have health and dental coverage thru work, but sometimes it gets a little depressing. Add in $250 in recent furnace repairs and well....sigh..minor pity party.Tomorrow is a new day, right?

**lanford66** · 01-24-2007, 08:24 PM

I too suffer from severe migraines. I thought mine were going away as I didn't have near as many as I used to, but seems lately with the "weird" Kentucky weather that mine have come back full force. Cheeses, smells, smoke (cigarettes especially) and other dairy products are triggers for me. I use Imitrex and have tried several others too, but thankfully my husband's insurance is great on the prescriptions. They have $30 co-pay at doctor and $60 co-pay for 3 month supply of meds. They usually send me 6 9-packs for $60. MY aunt has severe migraines also and she was paying $20 per pill. I was shocked at what the cost w/o any type of insurance. I am soooo thankful that I can get as many as I do as I usually stock up during the year so that I'll never run out.

**TheRootedNomad** · 01-25-2007, 07:04 AM

On the topic of migrain experiences .... both my husband and my oldest son are prone to them but don't suffer them on a consistant basis. If we catch them coming on we can treat them with OTC meds or perscription pain pills. I am very, very gratefull that they don't suffer these on a routine or frequent basis as they look (and without a doubt feel) miserable. To those of you suffering from these my heart goes out to you.

Now on to the medical fees....

**TheRootedNomad** · 01-25-2007, 07:26 AM

posted too quick and took to long editting

This is my soap box so I'll keep it very short compared to how long I could vent. This IS the one compelling reason I continue to work full time, the cost of health care. To add me to my DH's policy the price per week goes up considerably because I'm a "female of childbearing age". (DH works for a small company and they really work with thier guys and offer them multiple health insurance options but can't afford to eat as much of it themselves as a large company.) From what I've heard is out there though even the big companies don't offer much better. It's not any better if I pick it up either. The whole health care finance thing seems almost crimainal to me. As a family (and we are very infrequently sick) we pay by far more in healthcare insurance and co-pays than ANYTHING elsa. ........Forcing myself to stop now

**littlemotherhaywood** · 01-25-2007, 08:31 AM

I kwym. We very rarely get sick, but when we do, it seems we all get sick and it just compounds it. A few people have been telling me about their doctors that will call in scripts for the second child if they come down with the same thing as the first without seeing them. On the one hand, I think that's great and saves money. On the other hand, the same symptoms don't always equal the same illness and I would think there would be quite a bit of liability there. That's just me.

I'm really thankful that we have decent insurance. I know I'm complaining about pocketchange here. We only have to pay our premiums for ten months out of the year so it's at least a $700 savings over our previous insurance right there. Plus, the only deductible we have is if we have a hospital stay and that's only $400. We have a few thousand dollars in bills from my surgery last year. This would have been a nice plan to have. The only downside is that we have an HMO and it takes forever to get referrals and we have to jump through hoops to get them. I just know we have it better than so many.

I have a friend who pays OOP for his own insurance (several thousand a year for one person) with a $2000 deductible. I don't think he's ever used it in the six years I've known him. He's older (in his fifties) with a family history of several health problems. It just doesn't seem right that he has to pay so much.