Text 10738, 229 rader
Skriven 2013-10-15 10:26:36 av Roy Witt (1:387/22)
  Kommentar till text 10736 av Janis Kracht (1:261/38)
Ärende: APODs
=============
 Brer Janis Kracht wrote to Brer Roy Witt about APODs:

 >> I'm not employed...you're paying for my healthcare though. When I
 >> worked as a roadside tech here in Texas, I had no insurance except for
 >> Medicare.

 JK> Yep, happens.

Sadly, more frequently than not with the way more and more people are
turning 65 these days.

 >>>> A drug I take now is billed at over $20,000/per unit. That's on an
 >>>> average

 >>> Darn that's insane...

 >> Insane as in Obama Scare...

 JK> Heh.. he didn't the price for that drug, neither did he set the price
 JK> for this drug my neuro wants me to start.

That's because the money given to pharmacutical companys for research is
subsidized by gov't...Otherwise there wouldn't be any research unless
some rich person dies and leaves them a few million.

 JK> . that's just BigPhama.. I could on about that but it's not worth the
 JK> discussion <g>.

When you get on the Medicare rolls, your meds are subsidized by the SSA
(gov't) and you pay an extra premium for drug coverage (Part D).

 >>> I only use medicare for Hospital/Docs-in-hospital.. not for drugs or
 >>> doctor visits in the doc's offices.  That will probably change in the
 >>> future, well, it will change in the future, but not right now.

 >> You have to be on Medicare to use it, else you either pay out of
 >> pocket or an insurance company pays it for you. This isn't supposed to
 >> happen, (asking a female her age), but are you 65 yet?

 JK> Nope.  Since I have a 'dred disease' that's not ever going to go
 JK> away, and because I worked most of my life the gov't gives me some
 JK> $$.

I have one of those 'dred diseases' too, but the gov't never gave me
anything for having; the aging process.

 >>> Sure, 'they' said I don't have Relapsing/Remitting MS and my doc
 >>> disagrees with them.

 >> Unless Aetna calls for a 2nd opinion by one of their network docs,
 >> then your doctors opinion rules.

 JK> Heh.. not in this case.  It will take that other doc's 2nd opinion,
 JK> and then Aetna may still reject it.  Then I'll appeal their decision
 JK> if I really care to go on this drug, but it's so new.. I may just
 JK> tell my doc. forget it
 JK> :)

Does the maker of that drug have a program that allows you to receive that
med with little or no cost? I did that for a year, but I didn't like being
in a near coma and sicker than a dog, so I stopped taking it.

 >>> I'm one of those people who have had MS for years, and it's just a
 >>> nuisance.

 >> Well, MS is known to get worse with age.

 JK> Not necessarily.  Mine hasn't changed in how it affects me in over 20
 JK> years.. I just walk a little slower than some people some days,
 JK> really. That's what relapsing/remitting means.. it just comes and
 JK> goes.  For me, it mostly "goes" away.  There are different types of
 JK> MS, some people have a very horrid version and they're dead in a
 JK> couple years.  Some people have a type that is really rough on them
 JK> and they're in wheelchairs, possibly blind, and that's a mean one
 JK> that gets chronically slowly worse.  Most people though, have it like
 JK> I do.. it's just a PIA. <vbg>.  Now some day when I'm in my 80's I
 JK> may progress to a nastier version, but MS is damn weird.. it affects
 JK> everyone differently.. and by the time I'm in my 80's well... I might
 JK> give in and get a cane then Lol.

Make sure the cane has a high impact cattle prod so you can give the rude
teens of the day an experience in PIA...8^)

 >> Look at MJ Fox and see the
 >> results of MS with aging.

 JK> MJ Fox doesn't have MS.. he's got Parkinson's.

Right. Forgot what it was.

 JK> Very different disease ... My uncle had that one.. poor guy.  He
 JK> suffered in a similar way to MJ Fox before he died.

Kate Hepburn had it too. You could tell the difference in her voice after
she aquired it from her voice in earlier films. She lived to be in her
90s, so it couldn't have been all that bad for her.

 JK> These days they have better meds though for that one.

I would think so.

 >>> .  I have an apt. set up for a second opinion, but it's pretty
 >>> obvious Aetna doesn't want to pay the high fee for this new drug that
 >>> recently hit the market.

 >> ^^^^^^^^^^^^^^^^^^^^^^^
 >> Ahhh, there's the reason.

 JK> Everything with MS is very new except for the standard "CRAB" drugs
 JK> as they call them.  The CRAB drugs (Copaxone,Rebif,Avonex,Betaseron)
 JK> are even nastier drugs for what they do to you side-effect-wise
 JK> (injections every day, constant flu symtoms, nasty looking injection
 JK> sites), so I never agreed to take them.   The "new" drugs are very
 JK> very new, and while they'll cause a lot of infections they've only
 JK> killed a few people (seriously <g>) Anyway, that's why I am in no
 JK> rush <g>.  These are kind of like cancer drugs that affect your
 JK> immune response, hence all the infections.

Ahhh, yes. Treat the symptoms and kill the patient. I've seen that happen
before.

 >>> Yep, doc in the network.. My neuro is setting this up the 2nd
 >>> opionion.

 >> Cool. If the 2nd agrees with your doc, then it shouldn't be such a
 >> problem.

 JK> I know how Aetna thinks haha.. they'll reject it just because they
 JK> will hope that I won't push it..

They're counting on you to give up on it. If you continue to push it,
they'll give in rather than have the media find out about it.

 >>>>> Truthfully, I don't care about this one, but it makes me laugh at
 >>>>> Aetna's med. practices.

 >>>> They're just going by what the Unaffordable Healthcare Act has done
 >>>> to the medical practice. Many doctors refusing to take new patients
 >>>> due to the Obama-scare plan, many more are taking cash only.

 >>> Nope, not ours.

 >> Then you have a good doc who's working for your best interests. Same
 >> as mine does.

 JK> Yep, he's a good guy.  He knows how Aetna is..

I usually heard that about Humana, not Aetna. Which is why I switched to
Aetna last year.

 >>>> My doctor continues my
 >>>> coverage because it is Medicare and not Obama-scare.  Both my doctor
 >>>> and my RN sister know what's coming, they're not very happy about it
 >>>> because of the high costs of premiums and the worse health care that
 >>>> will be coming with those premiums.

 >>> Nah, Roy.. this is how Aetna has always been,

 >> I had Aetna in California and it was never like that. My employer
 >> changed carriers because their plan was too expensive, while Blue
 >> Cross' insurance plan proved to be better and cost less.

 JK> We had BC/BS for years when we had our own company, they were great.
 JK> Back _then_  they were extremely expensive.. I'm talking like 20-30
 JK> years ago. Trouble was once you have any 'dred disease' the insurance
 JK> companies charge you up the ass. That's when we started working for
 JK> another company to get insurance through them.

Unfortunately they're allowed to share your info with another insurance
company, which is why your history followed you around. If this was
pre-1965, you could potentially go from one doctor to the next without
revealing any of your past or present history.

 >>> Our plan really stinks to high heaven.. It's a very small company
 >>> and you don't get big benefits at place like that. You really have to
 >>> consider it more catastrophe insurance.

 >> My youngest daughter was hit by a car when she was 3yo. That hit
 >> twisted her left femur and broke the bone. She spent a month on a
 >> hospital bed in traction and Aetna paid every dime of it, while I was
 >> in the process of suing the driver for negligence. She walked with a
 >> noticible limp as the bone was healing and trying to catch up with the
 >> right leg. She still limped slightly at 23yo.

 JK> I'm sure everyone has an insurance horror tale for every good one..
 JK> it's the nature of the beast <g>.

 JK> Our plan is so bad, that for a procedure that you can get for a
 JK> couple hundred dollars in Europe, I have to pay something like
 JK> $1500.00 here in the US (that's my cost after insurance pays).  MRI
 JK> exams are ridiculously over priced in this country.  I had to get one
 JK> though to prove that I still have R/R MS though.

I'm scheduled to get an MRI soon, they're looking for any Wardism's that I
may have aquirred through Fidonet. 8^)

 >>> For us when it comes down to it, it won't be much different than what
 >>> we're paying now, but the coverage will be MUCH better, and copays
 >>> won't exist.

 >> That's what Obama says, but it isn't true.

 JK> That's what the program we will select will do when the time comes.

Skeptism on...

 >>>> How much did your premium skyrocket under Obama-scare?

 >>> It's will be about the same cost as we're paying now.. not much more.
 >>> It's the benefits that will increase.. dramatically.

 >> 8^( That isn't what's being reported by those who have signed up.

 JK> Depends on what plan you sign up for, Roy.  The one we're looking at
 JK> isn't cheap, but it's a much better plan for us compared to what we
 JK> have now.

Good luck with that...


         R\%/itt - K5RXT

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