Non-LB question/rant
Greetings, all.
Week three of my trial with LB - So far it's helping, but still not into the habit yet. At least it's helping me get some of the basic daily things done, but many larger tasks are still eluding me.
I need to rant for a moment and perhaps one of you can give a suggestion.
About 6 months ago, I gave up my business to do a long hike on the Appalachian Trail to raise money for a local charity here in Orlando. I had been without health insurance for some time and about every 3 months, I would go to my psychiatrist and pay $75 for a 5 minute med check and to write me 3 months worth of prescriptions for Adderall. Adderall XR, 30mg was around $110 for a 30 day supply with a paltry free prescription discount card I was able to get.
Now that I'm back, I need to get on my meds again since I'm basically trying to reestablish myself in a new career and am having a rough time getting organized.
My doctor's office, now says that because it's been so long since I've been in to see him, I have to pay like a new patient for the deluxe 10 minute visit (sarcasm) and pay $140.00.
Now it's going to be a while before I'm in a position where I have enough cash built up to get insurance again, let alone pay the super high price for medication, meanwhile, while all the soccer moms are getting Adderall for $10/prescription so they can keep up with their Type "A" personality schedules. For me, it's not a luxury, I need it just to function.
This stinks.
Do any of you have suggestions on how and where to get meds affordably, at least for the short term until I can get back on my feet?
*sigh*
Ron
Comments
RE: Non-LB question/rant
I located the following information on Shire's website:
Shire Patient Assistance Program
+1 866 325 8224 for All products
+1 866 325 8229 for Adderall XR
+1 866 325 8223 for Fosrenol
http://www.shire.com/shire/contact.jsp?ref=7
RE: Non-LB question/rant
I can't address the medication costs issue, but I have a friend who's an orthopedic surgeon working for the Cleveland Clinic. We've talked about such health-insurance issues, and I noted that the price that health insurance companies actually pay to doctors and hospitals is far below the nominal price of the services they bill for. He indicated that, as a matter of Clinic policy, it is generally possible for uninsured patients to negotiate fees down to the levels actually paid by insurance companies IF they pay in full, in cash, immediately when services are provided. Since immediate payment saves a lot of time and paper-pushing costs that would otherwise go to billing and collection efforts, it's actually a win/win for both patient and doctor. Of course Cleveland Clinic policy probably doesn't have any bearing on your doc's practices, but it might be worth asking about this or seeking a doc who will work with you.
RE: Non-LB question/rant
Thank you both for your help. The Shire prescription assistance may be a help for short time solution. First though, I need to get in to see my doctor. Unfortunately, the front desk staff at this facility are so programmed to deal with insurance that they seem thrown off by my request to self-pay and don't seem at all interested in trying to negotiate a discounted rate. $140 is what it will cost to get back in the door.
I asked if the doctor does sliding scale and was told that he will sometimes do a contracted rate, but in order to negotiate that, I have to have an appointment first and in order to get an appointment first, I would have to pay the $140. There is no direct way to speak with the doctor I was told.
Almost every doctor's office I've been to over the years, is run like they are automatically entitled to the countless dollars forked over to them by the insurance companies, and so, there seems to be little incentive to provide meaningful customer service. If other businesses, who aren't subsidized, ran their businesses the way most doctor's office are run, they'd be out of business in a hurry.
I don't mean to step on any of your toes if any of you are in the medical profession, but in the last 6 years since I've been a cash-payer for my medical services, I've become much more cognizant of the value I'm getting (or NOT getting) for my money.
Guess it's no meds for a while until I can get back on my feet and afford to see a doctor.
Ron
RE: Non-LB question/rant
muddyshoes,
Try looking for free clinics in your area since going without meds is probably not in your best interest. In fact (and I apologize for saying this since you probably already know), for "true" ADD/ADHD afflictions being off meds may contribute towards the situations where your ability to generate funds becomes even more diminished. In effect, at least for me, no meds would mean reduced effectiveness, which leads to reduced productivity, which leads to reduced income, which itself reinforces no meds, etc., etc., - kind of creates a self-fulfilling cycle of diminishing returns.
Sometimes misperceptions of viable alternatives like free clinics lead to missed opportunities - imagine, one trip to a free clinic may produce the needed prescriptions that can be used through the Shire program as a short-term solution, which in itself may be enough support to help enable the application of some ADD strengths (like hyper-focusing) to find a better solution. If for whatever reason free clinics won't work, then try something like walk-in clinics where you may be able to find doctors who will write a prescription for a much lower fee (I did this years ago when seeking a way to start other meds to deal with an ADD "companion" issue (a so-called "comorbid" health issue - see: http://www.additudemag.com/medical.asp?DEPT_NO=506&SUB_NO=3).
Regarding the fees doctors charge, I try to keep in mind what it's like these days to be a doctor. After missing out on incomes while attending medical school and residencies while the rest of us earned incomes, they are also often burdened with unbelievable student loans (often hundreds of thousands of dollars)... So right out of the gate they are in a tremendous deficit in relation to, say, their undergraduate peers who have been earning incomes for many years while the doctors worked hundred-hour weeks to get through med school and residency. And today, there are huge pressures from the insurance companies to reduce doctor's fees, tremendous stress on the job, and a competitive climate in some areas where there is an abundance of supply (too many doctors) in relation to demand (not enough patients), which puts tremendous downward pressure on the fees they can charge to try to catch up with the rest of us (like their peers who've been out earning the bucks for many years).
Though I too cannot afford medical fees at the moment (I have had no insurance for over 15 years by the way, and business has been off), I for one am grateful that people still exert the tremendous effort and sacrifice required to learn the skills necessary to become MDs so that they have the skill-set needed to help keep the rest of us healthy and alive. When you think, as you stated, that you want "value for your money," try thinking how doctors must feel knowing they spent years not earning an income, and most likely those same years entailed going heavily into debt, only to go into practice where many of the users of their services resent paying for all their many years of hard work and financial sacrifice - would you be willing to make a similar sacrifice under similar circumstances?
The real problem I think is this country's unwillingness to adopt a better way to deal with health insurance, but I think I'll just stop now, I've already written too much.
Anyway, try the free clinic thing or walk-in clinic alternative and see if that along with the Shire program can help get you through to a better situation.
I hope some of the above helps - good luck!
RE: Non-LB question/rant
Hi there,
I'm actually happy to see some discussion of the "hassle" factor, which while it isn't directly related to the Life Balance software, is directly related to the general topic of what it takes to live a healthy balanced life, and the shared experience of our ADDers in the community.
I'm personally very proud of the fact that our small business has good health insurance benefits. I try not to count the cost without also recognizing how grateful I am that I have access to the knowledge and skill of some really wonderful doctors. As someone else pointed out, there are often unrecognized sacrifices that are part of building and maintaining that practice so that it can continue to benefit you and its other patients.
My thought on reading your post was that ten minutes with a true expert may be more worthwhile than spending a lot more time (and perhaps even more money in the long run) with someone who knows nothing about you or your condition. :-)
Still, having spent some time on the telephone trying to straighten out a problem or two with the insurance companies.... I am sympathetic to how exasperating that whole process can be. I hope that it all gets resolved for you so that you can get the care that you need soon.
Remember too, that our web site, for all its virtues and its amazingly helpful community is no substitute for getting the advice you need from your own doctors and other medical professionals who have the expertise to guide your choices about your medications.
On the software side of things, if you are using Life Balance, you can also set up a project for getting back on track with your healthy routine, with some tasks for following though on any necessary paperwork, phone calls, and making those appointments. Think of it as a small scale project... and find ways to get beyond the obstacles.
Best wishes,
--Catherine--*
Catherine E. White
President
www.llamagraphics.com
Creators of Life Balance software
for Palm OS, Macintosh and Windows.
RE: Non-LB question/rant
Hi Primal and Catherine,
Thank you both for your replies to my dilemma.
I guess my problem isn't so much that the doctor is requiring a $140 visit as it is having to deal with a subsidized medical system that has few alternatives for people without insurance. This is when my sister, who has many female friends in their 40s and 50s who are all on Adderall, according to her, because it helps them get so much more done during the day. It lessens the reality of how serious and debilitating ADD/ADHD really is for those of us who have to struggle just to do stupid things each day like pick up that piece of paper we dropped, and have been walking over for a week.
This surge of Type "A" personality yuppy demand also serves to drive the price of these drugs up through the roof to over $100 for a 30 day supply of Adderall XR 30mg. Meanwhile, while I'm sitting in the doctor's office for half an hour or longer, young pretty female drug rep after drug rep walks into the office and smiles to the receptionist who quickly buzzes them in because they're bringing them more gifts or more paraphenalia to put around the office to promote the drugs they are peddling.
In one case last year, I was at the doctor with my mom who was having a heart stress test and the office was full of patients. It was usually a 1-2 hour wait. A drug rep came in with two trays of hot, prepared food in those aluminum foil trays. I looked through that little sliding window and the whole office staff was standing around talking to the rep eating, including the doctors. When one of them looked out at us looking in, she walked to the little sliding window and shut it. And by the way, just for my personal curiosity, I often ask these folks if they are drug reps.
I don't mean to discount the benefit of doctors. I realize they sacrifice a lot at the beginning and incur unimaginable debt. But they recoup that quick enough and before long are driving around in nice automobiles and living in nice homes. And sacrifice in one's late teens and early 20s is not like sacrifice in one's 30s or 40s.
Ugh.. I'm sorry to rant. I need to get back on my meds... somehow.
I just left the above so non-ADD people can see what it's like to have an ADD-induced rant. Your mind just wanders and grabs at every thought and considers every permutation of an idea, all at once, until you are so wound up in the midst of a thought-storm that you become paralized, unable to make a decision about what's going through your mind. And so, you do nothing, and feel ashamed that another hour or another day has gone by and you still haven't touched that simple list of things that would have only taken an hour.
To be able to think like a normal person, and process my thoughts in a linear way...I would give everything.
By the way - I did find a link to a free coupon for a month's supply of Adderall at the link below if any of you can use it.
http://www.adderallxr.com/resource/adhd_coupon.asp
Blessings,
Ron
RE: Non-LB question/rant
Hi there Ron,
In my experience, there are many things that can lead a person to feeling frustrated with the world, with ourselves, and with the little bureaucratic messes that we find ourselves in from time to time. You don't have to have ADD for that to happen!
Figuring out some small steps you can take to make things better for your self is often a good place to start to turn that frustrated and helpless feeling around.
From what you've said so far, you recognize that you function better when you have the medication that you use, and that the doctor will see you for that $140 fee. So the path is well defined, even if it is irritating! Believe in the power of your abilities to solve the problem (rather than empowering your disability).
First, take whatever actions you need to take to be healthy. You've already said that you know that's key to everything else.
That is going to be your highest priority project, in Life Balance software terms. :-)
Once you feel that you are back on stable ground again, take some time to figure out how you can get some support from other people who are in a similar situation. There is strength in numbers if you make those peer connections. For one thing, you know that you are not alone, and many people out there also have ADD and ADHD and you can share ideas on how to develop the coping skills you need. :-) The forums here are a good start, there are lot of other resources too. On a national level, you might want to join a group like ADDA if you haven't already done so. Here's link to that:
http://www.add.org/
Keep an eye out for events, classes and group lectures that can help you form a support network. To give voice to the issues you see, you might want to write an informed article to your local paper.
I know that all might seem like it is too far away right now. Just consider that some food for thought for once you are on your feet again. Your immediate list of empowering tasks might be quite different. That piece of paper on the floor might the one that helps get you unstuck. The point is to identify tasks that can step by step take YOU to a better situation.
In the meantime, know also that you have our wishes for your every happiness and success too.
Good luck to you,
--Catherine--*
Catherine E. White
President
www.llamagraphics.com
Creators of Life Balance software
for Palm OS, Macintosh and Windows.
RE: Non-LB question/rant
HI Catherine.
Thanks for the welcome!
I had my doctor's visit yesterday but was told that because it had been so long since my last med check I had to see the doctor as a new patient, my self-pay visit would be $250.
Having experienced the benefits that meds can make and knowing the detriments I experience when not on them, I kept the appointment and just 'charged it' rather than try to find a new doctor for less. By the time I got around to doing research and making an appointment, another 6 months would have gone by.
The office manager explained over the phone that because it was so long since my last appointment, the doctor would have to do another full evaluation, blah, blah, blah. As expected when I got into the doctor's office, he had my same file, asked the same questions as last year and in 10 minutes I was out of his office with a script in hand.
It really wasn't the money, it was the principle. In fairness though, the doctor did offer his next month's visit pro-bono and I got one of those free med kits for a free month prescription. Having no insurance this saved me over $100. I also found a coupon on Shire's site for a free month's prescription. I'm hoping I can use that next month until I can get back and start making money again after my 4 month fundraising hike for a local charity.
I am hoping that I can really work on the health and organizational areas of my life that are lacking and that LB will help me through.
Thanks again, Catherine, for your insights.
Ron
RE: Non-LB question/rant
Here a little suggestion from a distant voice......
My duaghter and I both have the affliction; although we use Straerra to medicate it at $125 a pop; and we are a cash med family too..... I can't help you with the prices; but here's a golden trick my daughter taught me.... Use your hyper focus to your advantage.
Turn on that hyper focus gene and then point it at the "getting organized need"
Grap a piece of paper and right down everything you think you aught-be-doing. Hyper your focus until it done: including that mundan pick up the piece of paper.
Now hyper focus on the list and anything you couldn't do that day put it in lifebalance and then check it off on the paper.
Now hyper focus on the list again; and put thing in a numbered order. just hyper focus your way through it force yourself to number them. I usually number by fives so I can reorder one or two as I go.
Now all along keep telling your self you can't "go" until everything is numbered.
Now you got a work list. And start at the top and work to the bottom; hyper focus on each number as you get to it; but relax cause you got your master plan. Never do number 2 before number 1 is checked off.
it's amazing and it's liberty to watch my daughter crank her list like that.... Granted the first 3 items might be; pickup socks; brush teeth; comb hair.... but once she gets rolling.. look out......
Ok time to faid back out; cause check lb site can be checked off my list...... on to number 32....
RE: Non-LB question/rant
Hi Ratz,
Nice to hear from you!
Happy New Year!
Jean