Showing posts with label medication. Show all posts
Showing posts with label medication. Show all posts

Wednesday, April 4, 2012

In which we survive yet another health insurance boondoggle

Tomorrow Big Guy finally goes for a check-up. He was scheduled for one in early January, but when we went to fill a prescription on January 2 we found out that his State-sponsored insurance coverage had been terminated. It took three weeks to find out why. It took five weeks after that to get the coverage reinstated. It was a long and ugly story, punctuated by two occasions on which we needed to get $200+ worth of prescriptions filled.

Big Guy has been covered for exactly 35 days now. Today the doctor's office called to say that they were trying to register him for tomorrow, but the system kept saying his coverage has been discontinued.

Yes, insert the expostulation of your choice.

Thankfully, neither Andrew nor I ended up in the ER with heart failure. Neither of us were detained by the police for criminal activity, either. Which goes to show that if you set the bar low enough, even we can count  every day as a success.

But there was actually more success than that: after a near-stroke-inducing phone call to customer service, Andrew excavated a name from his files and found the number of a woman who'd helped him last month. And that competent woman, bless her, was able to get the coverage reinstated in a matter of 20 minutes.

At any rate, it occurs to me that it might be useful to relate some of the tidbits of information we picked up in the course of this adventure, in the event that some of it's helpful to others:
  • Do not hesitate to involve your local elected official's office in resolving problems involving bureaucracy. With health insurance you'll have to either sign a HIPAA release or do conference calls with the elected's representative, but it is helpful to have someone working with you who can toss the state senator's name around.
  • Some clinics, even at well-known hospitals, will work with you or waive fees if you are working in good faith to procure insurance or have applied for state coverage or Medicaid. It's always worth asking.  Big Guy was able to continue seeing his therapist and psychiatrist for two months without charge. 
  • Some of the big-box stores (Walmart, Target, etc.) have reduced-cost prescription programs for common medications. One of Big Guy's meds was available for $10 from Target instead of $90.
  • Check with your pharmacist to see if there are price differentials between different forms of the same medication. We discovered that the cost for one drug dropped $70 if we switched from tablets to capsules. The doctor had no idea this problem existed.
  • If you're completely broke and don't have insurance, some of the Pharma companies will provide certain medications free of charge or at minimal cost. You have to prove financial need.
May you never need to use any of these tips. And if you do, you may email me in hysterics and I will give you my phone number and you can call me and expostulate for an hour and I will be nothing but sympathetic. I promise.

Friday, September 3, 2010

Meds

Several people have written privately to ask how we knew when we needed outside help for Big Guy, and how we knew we needed meds. We've been through the wringer for seven years now, so I've accumulated two or three cents' worth of thoughts on the topic. Here's what I know:

If you're thinking you child might just be going through a really bad stage, write down a list of the troublesome behaviors, and then set yourself a date four months later to review where you are. You need a benchmark against which to gauge progress. If things mellow, great. If they don't, or if they have gotten worse, get help. Stages pass; problems fester.

If the size of your child's reactions don't make sense given the size of the triggers, you're probably dealing with something bigger than you can resolve on your own. When you look for help, there are two things to know:

1. If takes a lot of lead time to get in for a psych evaluation. You want to start earlier than you think you need to; if things improve during the two months while you're waiting, you can cancel the appointment.

2. It often takes more than one try to find the right therapist and child psychiatrist. If you find someone and it isn't working, try someone else. And then try someone else. Don't assume that because one therapist is useless to you, everyone else is clueless. (On our first try we got someone who suggested using a star chart, when we were restraining Big Guy for two hours each night as he raged. Uh... no.)

Another reason to schedule an evaluation sooner rather than later is that some meds take a long time to kick in. Trust me, if you're dealing with depression or severe anxiety and you wait until you're in major crisis to start meds, you're going to be a really unhappy parent. You may have to wait 4-6 weeks for the full effect of the meds to kick in (that's after the two months you've waited to see the pdoc) -- and the meds dosages are rarely right the first time around. You have to ramp up to the right level, in stages. And sometimes one medication doesn't work, and you have to taper off that one while you're starting another. It is not a science. It's an extended study in experimentation.


I think a lot of people get their knickers in knots thinking about meds, because they forget that they are trying meds. If they help your child, great. If they don't, you can change your mind. It's a reversible decision. The main point of meds is to make it possible for your child to succeed in ways he or she can't, currently.

I'm not a medical professional, and can't diagnose more than any other mom. But if you are worried about your child and want to talk, you can email me at LotsaLaundry1 AT gmail DOT com.