While it's great I have insurance, I really hate how they sometimes don't cover stuff that I need. If I could afford to buy what they don't cover then I'd buy it. Except I'm not made of money and I can't work because I'm sick. (I get dizzy a lot and keep losing weight, plus I'm naseous a lot too). I swear I I hate my insurance!! Plus I have so much to worry about lately mainly due to my j pouch. It's just very frustrating. 

Original Post

Yeah not everybody is rich and can just pay for stuff. Some people can't work like me for instance. I have an intellectual disability and the j pouch would make it hard to work. Though my disability hasn't stopped me from doing anything. I did graduate from college in 2015 and got a technical certificate. I just had to work harder then everyone else to make it. Once I get better I plan on getting a doctorate in Social Work. Just have to put my dreams on hold for a little while. Some medications are expensive though which sucks when they're not covered. I think my mom's insulin would cost $1000 without insurance. I've had medications that would cost hundreds of dollars with insurance. I feel that if something is needed it should be covered by insurance. Too bad insurance doesn't agree.

I guess it depends on your coverage. My plan, Kaiser, has an option for doctors to get coverage for non formulary drugs when necessary. Doctors just agree to use the formulary meds first before going off the list. When ordering there is some sort of exception code they use to get coverage. It still is expensive, but at least there is coverage and once I reach my out-of-pocket maximum, I pay $0 co-pay. My out-of-pocket maximum is high ($6800, with a $4800 deductible), so I have to plan for that expense early in the year. Unfortunately, I max out by the end of February every year.

I'm retired and do not qualify for Medicare yet, so I worry about the ACA shutting down.

Jan

This has nothing to do with ostomies or pouches. 

But with insurance. 

I picked up a prescription the other day and my copay was 24 cents. Yes. 24 cents. Not complaining.   Just thought wow! Really.  I paid it. 

Keep the change. 

It makes no sense. 

Richard. 

Add Reply

Likes (0)
Post
Copyright © 2019 The J-Pouch Group. All rights reserved.
×
×
×
×