Oh my, I do dread what will happen when we roll over to medicare & back up insurance. It's worth more to me if we could just pay the high priced insurance each month. I know we use mail in express scripts and they will not pay the same at the pharmacy window then if you get a year prescription and they refill it for a 3month period at a time. Like that, our co-pay on non-generic drugs is $50, $20 for generic. But mostly all I can get at the store is temp meds like when you are sick, or first time fills, or ones that are on that $4/$10 for 3 months chart. But seems you have to only take one a day or the price goes up.

I know this is so maddening, try to not go crazy, the only thing that helped me was binge eating. I know that isn't good for me, but it was that or go crazy.

As Afforable Medical Coverage (Obamacare) approaches, I too am seeing a lot of dead ends and questions. No one knows what is going on, us or them. Hope it is all worked out by next year.

Julie,I cannot make paragraphs. But, I do know how to take care of your express script problem. You can initiate the quantity limit exception. Call up the insurance company, they will need authorization from Larry for you to talk to them on his behalf. You should get that on file. Otherwise they will bother you everytime you call. Once you get past that hurdle. Ask them to initiate the request. This means that they will call and fax your MD to get the authorization done. Quantity limits are the easiest ones to get done. You need to tell them that this is continuation of therapy and that Larry has been titrated to this dose (he was started at a lower dose and the MD worked up to this higher dose). Give the insurance you MD's fax # and phone #. They will call and fax. your MD. IT is easy for you MD to fill out the form and fax it back. When you talk to the insurance tell them that you want the request expedited. You want this done ASAP. Ask them what time this would be. For the place that I work it means that this will get done in 24 hrs. The authorizations are usually back dated for 3 months. Ask Express script. If this is true..then if you had paid cash then you could always go back and get reimbursed by the pharmacy. THe pharmacy would just have to reprocess the claim on the day that you bought it. Even now. You paid for a 3 day supply. Just get them to reprocess the entire claim for that date. They can just subtract the 3 day supply that was given to you. This is what I do with my new job. message me if you have any questions. Ruth

Julie: Blessings for our Ruth.

Now that you know, never allow a Student sit in on a first visit of anything. For the actual therapies, that is fine. But the initial evaluation counts as part of the therapy that is allowed and you want 100% regardless of whether you know the therapist or not. Like Bruce at our Outpatient Clinic.

You'll have to challenge the Estim. Always a bummer, but he needed it and it will be worth the fight.

See you have to get three issues at a time to keep you on your toes because you don't have enough to do. LOL Go easy, one thing at a time. So glad you enjoyed your visit with Tina and Louis. And I do hope you get some rain soonest. Debbie

Ruth, thanks so much for your help. The nurse from the urologist office called this morning and said the order was put through. Thanks for your help with these big drug companies too. This was a prostate med that Larry always takes and we still had to jump through the hoops to get it approved. I will go back tomorrow and get the rest. Hopefully, I will not have to go down this road next time he needs a refill.

I wish I could help you with the paragraphing.

((hugs))

Julie

The paragraphing is the first icon on top of this box on the left, when you're writing a reply. It looks like a key hole. The prompter (arrow) lands there by itself and "toggles" you to no paragraphs, without you clicking on it. Likewise it will underline on it's own will, or make the print bold as it's doing here, because the prompter touched it. I get tired of doing it, but just put the arrow back to the correct icon and click and it will toggle back to normal.

Well Julie all i can say is ARGHHHHHHHHHHHHHHHHHHHHHHHH. hang in there nancyl