Can't find it, and with-o it I am in heap big trouble (rant)

Discussion in 'The Watercooler' started by susiestar, Oct 6, 2008.

  1. susiestar

    susiestar Roll With It

    WHat is IT?

    Vit D.

    There is no commercial injectible form of Vit D according to the doctor and the pharmacy. My insurance co has their OWN compounding facility, and they don't make this vitamin injectable. They say to take it orally.

    been there done that. Barfed on the tshirt.

    I spoke with-the doctor's office. Of course at 5 pm so I can't call back tonight.

    The insurance co SAID they have it and cover it. But they don't. Found a place that will, but they don't do my insurance. Found a different location of SAME pharmacy (same name anyway) and they haven't ever made this, but will get info and see if they can. Oh, and have I tried the oral form.

    (At this point i want to scream).

    Yes. I have. Can't tolerate it. That is WHY we are looking for injectable form.

    So the 2nd location of same pharmacy will call doctor and see if they can make it. But all bets are off on the cost.

    Why is it we pay a fortune for medical insurance, can someone tell me?

    Cause I am dang tired of messing around with this - can't find a doctor to trreat it, can't get an appointment when I do find a doctor. Then can't find a medication to treat it. Now can't get ahold of insurance when I DO find the medication and the doctor.

    Somebody stick a spork in me. Cause I am just about DONE!!!
     
  2. nvts

    nvts Active Member

    Hey Suzie! I did a search and noticed that quite a few of the injectible vitamin D treatments are for people on dialysis. Is there a urologist nearby or a dialysis clinic? You might be able to find out where they get theirs.

    I just searched under "injectible vitamin d" and found a ton of info.

    Sorry to see you going so nuts!

    Dogs gotta go out, talk to you later!

    Beth
     
  3. DammitJanet

    DammitJanet Well-Known Member Staff Member

    Find the actual companies that make the injectable vitamin D then go to their website and get their number for patient assistance. Call them.

    I was talking to a rep from Glaxo just the other day and you would be amazed at just how many programs they have to help patients that we really dont know about. If you can find the Big Pharma company...I would call them and simply ask them to help you get this stuff through your insurance company or if they cant do that...for a program to help you access it.
     
  4. susiestar

    susiestar Roll With It

    THANK YOU THANK YOU THANK YOU THANK YOU THANK YOU!!!!!

    With commercially made preparations the insurance will pay for them. It is the compounding they won't pay for - and I was looking at over $100 per WEEK according to the rough calculations of the compounding pharmacy!! We just can't pay that. Broken bones and joint replacements would be financially less expensive. And that is a crying shame.

    Beth, with your help I am going to call the endocrinologist's nurse back tomorrow and ask/tell her that we need to use one of several brands already made.

    I see very little reason to re-invent the wheel, unless they have a compelling reason, do you?

    Again, Thank you all!
     
  5. nvts

    nvts Active Member

    Wonderful! I'm so glad you're getting a little peace of mind for the night!

    Let us know how it worked out with the endo tomorrow!

    Beth:nurse:
     
  6. susiestar

    susiestar Roll With It

    I used a different search engine than I was and came up with a number of Vit D injection products. I called the insurance co specialty pharmacy and they have ONE of the TEN that I discovered. I got the name of that one, and called it in to my endocrinologist's nurse. I told her that we HAD to go with the one the ins co had. If that didn't work THEN we could try something compounded, and MAYBE the ins co would pay for it or pay for part of it. But we HAD to try the commercially made one first.

    I hope she understands, and can get teh doctor to work with me on this one.

    Susie

    ps. Thanks again for your help!!
     
  7. nvts

    nvts Active Member

    That's great! It drives me nuts when they just throw up their hands in the doctors office AND the insurance companies and leave us floundering!

    I hope this one works. If not, then most insurance companies step away from their formulary (which is the list of medications that they readily approve) and will authorize with a slightly higher co-pay, so don't go straight to them compounding it. It could end up WAY more expensive for you.

    Here's what I mean.

    Most ins. co's have a formulary, which means they buy generics and name brands from one or two of the major pharmaceutical companies in bulk thus their cost is lower. If it doesn't appear on their formulary they first want you to check with the dr. to see if they can switch to another type of medication (extremely common with antibiotics). If they can't due to an allergy, oversaturation via past usage, etc., the dr. writes a letter stating as such, it goes to a supervisor/advising nurse to go off formulary. It usually has to have a different chemical composition to get authorized, but ins. co's are hesitant to say "no" because it makes them extremely exposed if something goes wrong.

    THEN if (for some reason) none of them on the market work, it goes to compounding which you can fight with the insurance company about how much you're required to spend out-of-pocket AS WELL AS calling the company that produces the other products to see if they have an assistance program.

    You might also want to look up that company that Montel Williams has been actively involved with that helps families that can't afford their medications.

    Don't settle for chalky bones Susie! I'll help you dig if you need it! ;)

    Beth
     
  8. susiestar

    susiestar Roll With It

    Thanks Beth!!

    We are really really lucky with our insurance pharmacy benefits. It is a 3 tier system. First tier is ANY generic, formulary or not, for $10. Second is SOME brand names for $20, third tier is ANY brand name for $30.

    NOT all companies with the same plan have this pharmacy benefit with our insurance co. husband works for a HUGE company (a small offshoot, but still part of the whole when it comes to benefits) and they DEMAND certain things in the insurance plans. That way I am pretty sure if I can find 1 or 2 injectable versions to try, then the company will force the insurance to pay for compounded version from somewhere. Confusing, but until today I didn't realize that not al generics are formulary, just thought they were all 1st tieer. We do pay out the wazoo for this insurance, but we are not changing it!

    I really really appreciate your help Beth!!
     
  9. Marguerite

    Marguerite Active Member

    Is there any reason you can't get your Vitamin D through daily doses of sunshine? I know winter can be a problem, it is very difficult when you get short, overcast days. But again there are ways to find safe artificial sources of the right UV light. Or is your skin too pale? I do have this problem with easy child 2/difficult child 2 - she needs Vitamin D because she burns too readily so she covers up against the sunshine.

    I'm glad you found a source of injectable.

    Marg
     
  10. susiestar

    susiestar Roll With It

    Marg, My body just doesn't make Vit D no matter how much sun I get. AND I get very very ill (rash, skin gets a strange appearance, headache, vomitting, AND fever) if I am in the sun for 20 minutes - and that is WITH sunscreen. I have tried EVERY source of Vit D that is oral - diff brands, liquids, different forms of Vit D, prescriptions of Vit D, but I end up with the headache, vomiting, and throwing up with ALL of them.

    Most unpleasant, I must say. I have quite a collection of clothes that block out the sun now. they are a must have because even being in the sun long enough to take a kid to school can be a problem. We are hoping the Vit D will help that too. Or at least the doctor ir.
     
  11. judi

    judi Active Member

    Hectoral and Zemplar are both Vit D analogs that are injectable. Both are expensive but used often by the dialysis population. I know Medicare covers it.
     
  12. DammitJanet

    DammitJanet Well-Known Member Staff Member

    There ya go...if Medicare D covers it you can probably get your insurance to cover it.
     
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