a long whine

Sorry to read that you're experiencing all these hassles over med, Geezer. Hopefully your doc's appeal for Rinvoq will get approval ASAP, but with holiday season now upon us speed-in-processing likely will be dicey. In the meantime try to stay calm and avoid known irritants to diet, rest as much as possible-- you know those familiar ropes to fight off flares. *** The whole Rx situation in U.S. seems to be problematic; I even have a 60-ish neighbor with PH.D. in psychology who has a very demanding workload treating acutely-ill kids, who lately is having trouble getting a personal longterm Rx refilled by Walgreen's! (The local pharmacy keeps reporting that warehouses are either at low supply or running out of the med entirely.) *** Wishing you good luck with the Rinvoq issue!!!!! / Old Hat (40+ yrs with left-sided UC; in remission taking Colazal)

I hate being at the mercy of insurance. I am still on employer insurance. For the past 6 years we always had Blue Cross Blue Shield, but they are switching to United Healthcare Jan 1. Not looking forward to having to get preauthorization for remicade with a new company. I have my fingers crossed that they won't change anything.

Hopefully, they will approve Rinvoq soon. This disease is hard enough to deal with without the insurance BS. It's enough to stress anyone to the max. Hang in there.

Champ and everyone....Thank you. I understand that insurance companies don't want to pay out for old people; especially when the drug companies charge so much for their magic drugs. I just wish our doctors who prescribe drugs for us wouldn't have to jump through so many hoops to get their prescriptions approved by some group of insurance groupies. I'm fortunate enough that my gastro doctor is a super great doctor and good human being. I dread the day that he retires! Anyway....the doctor's staff are trying to deal with the insurance and I'm trying to deal with the drug company. Time shall tell. I really hate it for ALL of us, that there ARE drugs that can help us, but we have to beg everyone, to have them paid for. Taxpayers pay trillions of dollars to send bombs to kill humans in foreign lands. Wouldn't you think our tax dollars would pay for everyone to have health we could live with? Sorry...just feeling a bit bitter and down at the moment. sheesh One would think I'd be used to this by now. I'm and OLD guy now...74 in a few days; so for me it's just the 'norm' of being sick. I do hate it for the younger folks who have to deal with this horrible illness now and in the future. The people in this forum have been so kind and helpful over the years; just THANK you ALL and keep up the fight.

Geezer and everyone I have a question. Maybe a dumb question.
From reading other posts I got under impression that Medicare plus supplemental would pay for meds your doc prescribed without requiring try other meds first.
I am not on biological and will be eligible for Medicare in 2023. So… I am trying to learn.
Don’t want to hijack this thread but I am struggling and getting mentally ready for higher meds, although it’s very scary.
Isn’t it Medicare plus supplemental is the best choice to get the meds you need?
Reading your story makes me think I am missing something.
Could someone explain how it works…

Geezernow, I do hope your dr's office get the approval on the appeal. How long ago was the appeal done, do you know by chance? Keep us posted, totally understand where you are coming from.

Happy Birthday early.

Geezer … did you try calling rinvoq and see if they have a patient assistance program for people who do not qualify for copay programs? It’s well worth the time and effort. I ask because I am on Medicare too but I get my Aimovig (migraine med) injections from the Amgen patient assistance program (different from the copay program which Medicare patients are not eligible for).

Geezer I just looked it up. Abbvie does have a program for those who cannot afford the medication — call them to see how to qualify and if you would. https://www.abbvie.com/patients/patient-assistance.html?utm_source=myAbbVie-Assist-URL

I’ve also used Apriso’s assistance program and uceris. I’ve found on the whole the representatives are very nice and helpful to deal with. It takes a while to fill out the applications and get qualified but so worth it in the end.

Geezer -- I am confused about your insurance coverage. If you are on Medicare isn't that your Primary insurance and Blue Cross would be your supplemental and covers what Medicare doesn't? Or are you using a Blue Cross Medicare Advantage policy?

We are still in open enrollment right now so I think you can switch plans for 2023. Something you might want to look into.

I'm sorry for the insurance confusion. LOL I tend to confuse myself. LOL I have Medicare parts A&B but not the prescripton coverage. I have Bluecross/blueshield as my primary which covers my drugs. Also have Tricare which picks up a good part of my co-pay after BC/BS. I've TRIED to get my pharmacy through Tricare but was told that since I have my other insurances, it won't pay the bulk amount. As I've said many times before, I'm not the brightest bulb in the hallway. I shall call my gastro doctor in the morning for an appointment to see if I can make heads or tails of it all. As it stands right now, I'm beginning to flare, am taking Mesalamine, and am just plain worried

Flowers...yup, retired but have bluecross from work. Also have Tricare from military retirement. HOPEFULLY...my doctors staff and my insurance MAY get it straight TODAY. Time shall tell. Insurance is so confusing to me. Medicare is my primary, Bluecross is secondary, and Tricare is third but I don't have part D of Medicare. Anyway....after yesterday and all of the back and forth doctor and insurance calls, I can only HOPE it's all straight now. We'll see. LOL I'm only me, but can only imagine the turmoil so many folks find themselves in, in dealing with pharmacies and insurance. Having an ongoing illness is bad enough, but dealing with all the bureaucracy can be overwhelming. I do thank all of this forum for any help. Sometimes, just the one kind word helps more than any drug we can fight to get. Stay well, be safe, and enjoy some of every day.

LOL I'm still riding my dead horse. LOL Finally, my insurance gave it's approval for Rinvoq for one year. I suppose they hope I'll be dead by then. LOL Now I'm again in the 'waiting room', awaiting CVS Specialty pharmacy to fill the prescription. It's been several days now; so hopefully, it will be done soon. sheesh After being jerked around for over a month with this medication ordeal, I'm now in a flare. I'm sure I helped myself by being stressed a bit by the unknowing if I could even get the new drugs. So, as of today, I'm still in limbo, but getting closer....I HOPE! I did apply for all of the patient assistance, co-pay assistance, and the other programs Rinvoq and Abbvie say they provide. As always, I was told, oh yes, by all means we can help you. Then, once I tell them I have Tricare along with my BlueCross, it's always the same answer...sorry, you don't qualify due to your having Tricare. sheesh Maybe I'd be better off if I just canceled all of my insurance!!! LOL Anyway, sorry for all the whining; as you all know, pain, discomfort and worry do funny things to our thought process. Just wanted everyone to be aware of what they may have to endure with insurance and meds. Every enjoy the upcoming holidays and stay well!!!

Flower...Thank you and I totally agree about insurance dragging their feet. But, it isn't them who are sick. LOL I'll be quiet now and no more whining from me.....for a while I hope. You feel well and happy holidays to you and all.

Ditto what Flowers said