health insurance

20 October 2008

Health Insurance – 6 ways to Maximize Your Coverage

When finances get tight, it’s more important than ever to be sure you’re getting the coverage you need from your insurance company. But for people with migraine, or chronic daily headache, et cetera, things aren’t always so simple. Sometimes it turns out that, when you most need the help, the insurance company lets you down.

Image © Yury Shirokov | Dreamstime.com

We’ve talked about this issue before. We discovered from our online health insurance poll that about 30% of you still pay at least 50% of the cost of your medications out of pocket. From many of your comments I’ve been reminded that we’re often reluctant to use treatments that could help because of the cost. And remember the challenge of getting the drugs you need when you need them.

So what do you do? Well, our visitors have risen to the challenge to share their best tips in the most recent Community Question. I’ll let you read their comments for yourself, but here are some brief ideas to make sure you get the funding you need, when you need it:

Be involved – be involved in your treatment, be involved with the insurance company – don’t just sit back and accept whatever happens.
Be persistent – don’t give up! Go through the process, ask questions, ask "why", ask for information, talk to someone else, find another doctor.
Be creative – think outside the box. Try to see it from the other person’s perspective. Keep your eyes open for other options.
Be organized – keep records on file, have a copy of your insurance policy, take note of who you last talked to on the phone.
Be informed – know the facts and myths about your treatment, know the latest options and discoveries (hey, you’ve come to the right place!), know the official policies of your insurance company, know the law, know about the options the drug company may offer.
Be bold – don’t be afraid to ask and question and ask again. Remember, you’re not only helping yourself, you’re helping those that come after you in a similar situation!

But you’ve heard enough from me – go and see what our visitors had to say in our new article – Insurance: Getting covered with headache and migraine

12 March 2008

Rationing drugs due to insurance concerns

James Discoveries & Stats, Medications, Tips 2

Let’s face it. Stocking up on drugs is not an idea that makes your insurance company happy. But the challenge of having the right drugs on hand at the right time is adding to worldwide migraine pain.

This is actually a study from June 2007, but it’s worth looking at. Dr. Robert A. Nicholson, assistant professor at Saint Louis University School of Medicine and School of Public Health headed up a study of 233 migraine sufferers who took triptan drugs. Here’s what he found…

42% of patients said that their insurance plan restricted the number of triptan doses covered each month. 37% said they had a prescription for triptan drugs, but hadn’t filled it because of the cost.

Of those with no limitations, 79% took a triptan at first sign of a migraine attack (as most doctors recommend). Of those with prescriptions, only 49% took a triptan at the first sign of an attack. Of those who took a triptan right away, 51% said that migraine had a severe negative impact on their lives. But of those who hesitated to take the drug, 79% said that migraine had a severe negative impact on their lives. In fact, one in three of these people ended up in the emergency room at least once in the previous 12 months.

In summary – if someone’s insurance company is limiting their triptans per month, or if cost is keeping people from using them, they have more severe attacks and more frequent visits to the hospital. Not only does this seem bad for health, it doesn’t seem very cost effective for the insurance company.

The good news is that triptans, when used right away, are working.

One more interesting note. Dr Nicholson notes that many people delay in taking migraine medication because they want to be sure it’s really a migraine. Don’t worry, he says. Statistics show that your first guess is almost always right.

What can we do about this? Look for another insurance company? Find other alternative treatments (for when your pills run out)? What’s your strategy?

28 January 2008

Does insurance cover you?

James News, Tips 1

Is your insurance really a help, or not? I was curious to find out how much of your treatment and medication is actually covered. You answered by taking our poll! Here’s what you said:

Q: How much of your treatment has your insurance covered?

Insurance poll results

Thanks for your responses! Quite a few of you have (amazingly) gotten full coverage. But there are still about 30% who must pay at least 50% of the cost out-of-pocket. Ouch!

Have ideas and stories that will help others make the most of their insurance (honestly, of course)? Share your ideas in our current Community Question.

Meanwhile, read Lori Andrews thought on how to Fight for Your Health Care (US article, but much applies in other countries). via Chronic illness Pain Support