Insurance Company Decides They Will No Longer Cover Compounded Medications

Today I called my compounding pharmacy to refill my prescription for Quinacrine. 

I received a call back from my pharmacy saying that the medication is no longer covered by my insurance, which means paying $95 out-of-pocket per month instead of $25 per month.

Of course, this is not the news I wanted to hear, nor was I expecting to hear.

So I called my insurance company, and after talking to three different people, I was told that they have decided to no longer cover any compounded medications.

I explained that I have lupus and RA, and that this medication is working for me, so would they provide an exception?  Of course, the answer was no.

It’s really crazy though that they covered it last month and are no longer covering it this month. 

Insurance companies make these willy nilly decisions and they don’t bother to think about who they are impacting and what the consequences of such decisions are.

At this point, because the medication is working for me, it really doesn’t make sense to go off of it and try something else, even if it would mean a more manageable cost per month. 

$95 a month is going to be hard to swing, along with the other medications I take costing $70 per month, and now that I am seeing an out-of-network therapist that is charging me $125 a week. 

Holy credit card debt here I come.  I guess that’s the price you pay for some modicum of health. 

I guess I’ve always known that being on a medication that is no longer commercially available in the United States, I run the risk of just such a thing happening.  But I don’t think I ever imagined that the insurance company would make a blanket rule refusing to cover any compounded medications whatsoever. 

And it’s always beyond frustrating to talk to insurance companies because they just don’t get it.  They aren’t doctors and they aren’t patients.  They’re just cogs in the wheel of the medical industrial complex machine.

They are talking heads.  They are mouth-pieces.  They are simply uncaring and unsympathetic.  And they put those of us who are chronically ill and in need of meds to function in a really crappy position. 

I’m not there yet, but some people have to decide between eating or taking their meds.  And that just shouldn’t be.

I hate it when I am forced to make decisions about my healthcare based on the dictates of my insurance company and nothing else. 

I know that they are customer service people, but I really resent being asked the question at the end of the phone conversation today: “Is there anything else I can help you with today?”

First of all, you didn’t help me.  You just kind of ruined my life. 

Medicine X 2014: It’s Okay Not To Be Okay

I had the honor of attending the Stanford Medicine X conference in California this past week. 

Why that title – “It’s Okay Not To Be Okay”?  Because that is truly the most important thing I took away from my Medicine X experience.

Returning from Michigan to New York after my Dad died, I had a much smaller support system than I had in Michigan.  And initially, I felt like I was going to California in a fog.

I knew I had to get on a plane to go to a conference, but beyond that, my mind was in a million other places, not least of which was making the decision to still attend Medicine X, after my Dad’s death just three weeks earlier.

So I went to this conference, and I was not okay, not by any stretch of the imagination.

But it turns out that this was probably one of the best things I could have done for myself, not just in general, but especially during this difficult time. 

Because Medicine X is a judgment free soon.  In terms of the patients at the conference, we all have our things – whether it’s lupus or RA, wearing a prosthetic, or having a rare disease that no one, not even doctors, have ever heard of.

It was the first time since being back from Michigan where I didn’t feel like I had to lie and tell people I was okay when I really wasn’t. 

Medicine X is an environment that boosts you up, makes you feel like you are not alone.   

I was truly inspired by the people I met there.  In fact, I am really at a loss for words to describe the transformative experience that was Medicine X. 

And it was hard coming back to reality.  To a world with no wellness rooms, where people can’t just look at you and know you need something, and don’t look down on you because of it.

Most of the people that I hung out with at Medicine X were younger than me, and I was amazed to the degree that they have their shit together.  When I was their age, I was newly diagnosed, and questioning every aspect of my life – and at times, whether or not I wanted to live it.

Those were dark times for me.  And maybe my life would have been much different had I discovered Medicine X then.  But it has certainly changed my life now, and completely for the better. 

There were definitely some doctors that were more evolved than others.  But honestly, while it was nice to be able to engage with medical professionals and pharma, it was the patient interactions that really meant the most to me.

When I had a meltdown during the pre-conference day, before I knew it, people were huddled around me, seeing what I needed and what they could do.  And that was enough.  To be surrounded by people I had literally just met, really meant the world to me.

And my mom and boyfriend both commented that I haven’t sounded this happy in a long time.

I was worried that with life having other plans, I wouldn’t be that into the conference, but I really was.  And I know that my Dad would have been proud that I went, despite everything that has happened in the last month. 

And ultimately, I’m glad I went.  I made new friends.  Not just superficial see-you-when-I-see-you friendships, but I barely-know-you-and-I-still-bore-my soul. 

Most importantly, I met people like me.  I was able to be myself, warts and all, and I learned how connected our patient stories are, whether we live across the street or across the world. 

There are many people I have to thank for making this experience one of the most influential in my life, to date.  But I’m only going to name one of you, so I don’t inadvertently forget anyone. 

I have to thank my roommate, and now kindred spirit, Emily Bradley (A.K.A. ChronicCurve).  You said that Medicine X places you with a specific person for a reason, and I believe that 100%.  I couldn’t have had this Medicine X experience without you and am truly grateful to know you (you’re kind of like the undergraduate version of me).     

I received a very generous scholarship in order to attend Medicine X as an ePatient Delegate.  So of course, I have to thank the organizer of Medicine X, Larry Chu, the ePatient Advisory Board, and anyone else behind the scenes who made it possible for me attend. 

If you want to gain more insight into my Medicine X experience, hop over and take a look at my Twitter feed (@LeslieRott). 

I can’t say enough about this experience.  It’s really hard to put into words.  But I will say, and hope I can say, that I’ll see you next year Medicine X, and I’ll be prepared to bring my A game. 

The title of this post was inspired by Britt Johnson (@HurtBlogger) and Joe Riffe (@ProstheticMedic), and the song “Who You Are”, by Jessie J:

“[…] Don't lose who you are in the blur of the stars!
Seeing is deceiving, dreaming is believing,
It's okay not to be okay...
Sometimes it's hard to follow your heart.
Tears don't mean you're losing, everybody's bruising,
Just be true to who you are! […]”

My New “New Normal”

When I first got sick, I had to re-evaluate my life.  I had to adjust what my expectations of normal were.  And now, after the tragic and untimely passing of my Dad, I’m finding that I once again have to re-evaluate my life and my priorities, and try to return to “normal” functioning, whatever that actually means at this point, I’m still trying to figure out.

There are already things that have changed…

Right now I am eating to live, not living to eat.  Sometimes food tastes good and sometimes, it tastes like nothing.   

Days that I get up, get out of bed, put on real clothes and do more than stare at the wall are a good day.

I know my dad wouldn’t have wanted my life to stop because his did, but it doesn't feel right.  It doesn’t feel right trying to move on from this.  It really doesn’t.    

Even though I know he wouldn’t have wanted it this way, it feels macabre to do the things that my dad no longer can.

And there are things we would never have thought anything of before, that become meaningful now…

We will never again think of a cellphone call that goes unanswered as no big deal.

We will never look at a rain storm and not be filled with dread.

We will worry that something bad has happened when someone arrives home later than expected. 

Someone recently said they hoped my illnesses were giving me a break, but honestly, I would rather that my physical pain and my emotional pain match, rather than being totally engulfed by emotional pain when the physical presses me to move forward, to move on.

Right now I feel like my brain is mush, and like I’m walking at a snails pace. 

Many of you reading this right now are probably thinking that I need therapy.  And I do, I know I do.  But right now I need to sit with all that has happened and deal with it in my own time before I bring in a stranger to help me work through it.

When I got my diagnoses, I walked out of the doctor’s appointment feeling like the world had irrevocably changed, but I was the only one to notice it.  In this case, the world has irrevocably changed, but I’m not the only one to have that feeling.  Besides my family, it has become apparent over the last several weeks that my Dad was loved by many, many people, and he made lasting impact on those that had the pleasure of knowing him. 

Two weeks ago, I could barely walk, barely breathe, was nauseous and dizzy.  I could barely keep it together.  This week, I am being forced back into somewhat of a routine, trying to prepare myself for all that I had originally planned to take place in the coming weeks. 

Maybe I’ll get back into the swing of things by doing new things.  I’ll be attending the Stanford MedX Conference from September 3, 2014, to September 8, 2014, and I’ll be attending the ePatient Connections Conference September 15 and 16, 2014.

My family has urged me to fulfill these commitments despite everything that has happened.  They tell me that my Dad would have wanted me to forge ahead, despite his tragic loss. 

That’s really the only thing that’s keeping me moving forward right now – that my Dad would have wanted it that way.