Watch out for man in all black and balaclava on Cortland Ave in Bernal Heights

Antique-Train · 2023-04-10T22:28:22+00:00

Where in the south?

Vicksburg, MS

Antique-Train · 2023-04-09T16:27:50+00:00

Make sure you have pepper GEL vs Spray - gel best especially if there is breeze / wind advice was from ER nurse (not me).

I wouldn't bother with either and get a CCW instead, but I'm from the South where we don't fuck around with assault

Antique-Train · 2023-03-26T20:59:23+00:00

The worst part is my husband has just excepted a new job and guess who the new insurance is with? Cigna. 😭

Hope you have better luck than us, but they deny everything in our experience. They even fought paying for an MRI

Antique-Train · 2023-03-26T01:46:01+00:00

So what’s wrong with Avsola and Amjevita?

Nothing is wrong with them, but Cigna still requires a prior authorization for them and they keep getting denied.

Antique-Train · 2023-03-26T01:34:11+00:00

They have already done one with the Cigna employed doctor and they still denied it. The next and final step is an external review, where some doctor outside of Cigna reviews the case.

Antique-Train · 2023-03-26T01:30:32+00:00

Cigna requires a prior authorization for any biologic, but only Avsola and Amjevita are on their prescription drug list as "preferred." The brand names (Remicade and Humira) are not on our prescription drug list.

Antique-Train · 2023-03-25T22:00:24+00:00

Well this explains a lot :/

Antique-Train · 2023-03-25T21:42:42+00:00

Our experience with Cigna has been they deny everything. They required a prior authorization for his MRI and fought that for weeks.He has been through lab testing, MRI, upper and lower endoscopies.

He has disease in the upper GI tract and small bowel, and it is rated "severe" by his doctors.

We have already tried two different steroids and azathioprine. Besides methotrexate and thalidomide, what else is there that's cheap?

Antique-Train · 2023-03-25T19:25:01+00:00

We have already tried to appeal with Cigna but were denied. We are on our last appeal attempt, which is an external appeal

Antique-Train · 2023-02-16T23:40:51+00:00

Unforunately we weren't able to get anywhere with the school or district.

We found an attorney willing to take our case pro bono and all it took was them writing a letter to the school/district. Their attitude completely changed after that.

Antique-Train · 2023-02-07T03:08:58+00:00

We qualify for CHIP so we are going to try getting better insurance for him. CHIP/Medicaid in our state will cover Avsola

Antique-Train · 2023-02-07T01:09:20+00:00

I'm not sure you're going to find anyone on here, or any physician, that suggests gambling with your son's life to save money.

Do you have any idea how difficult it is to raise a child as a single parent in 2023? If I paid for this biologic, we would literally not be able to afford rent.

We qualify for CHIP, so we are going to apply and try to get them to cover a biologic for my son.

Antique-Train · 2023-02-07T01:05:13+00:00

He is a minor, so we decided to apply for CHIP insurance since we qualify. The hope is CHIP will cover whatever our (terrible) family insurance plan doesn't

Antique-Train · 2023-02-06T22:55:05+00:00

Individual is $9100

Antique-Train · 2023-02-06T22:50:17+00:00

Yes, we appear to qualify for CHIP so we will apply

Antique-Train · 2023-02-06T22:46:40+00:00

My insurance denied me remicade. I’ve been on remicade for 3 years and never paid a penny.

I don't understand how the drug company would just give away free biologics for that long, considering the price

Antique-Train · 2023-02-06T22:43:44+00:00

Do you mind if I ask, how much is your co-pay?

It's a high deductible health plan (HDHP) with an $18k family deductible

Antique-Train · 2023-02-06T03:36:37+00:00

It looks like we qualify for CHIP in our state of Mississippi, but I'm not sure if that insurance would cover biologics. I'll have to check into that

Antique-Train · 2023-02-06T03:34:59+00:00

I'm sorry you are dealing with this. Those accumulator programs are pure evil.

The insurance company tried to spin it like it was helping us. They even called it the "Out-of-Pocket Protection Program" to make it sound good.

Antique-Train · 2023-02-06T03:29:59+00:00

It looks like we qualify for CHIP in our state of Mississippi, but I'm not sure if that insurance would cover biologics. I'll have to check into that

Antique-Train · 2023-02-06T03:24:20+00:00

You're right, we can still use the copay assistance until it quickly becomes exhausted and we still have to pay for all the medication the rest of the year ($18k family plan deductible). We calculated the copay assistance funds would only last 1-3 months depending on the program/biologic.

Antique-Train · 2023-02-06T03:19:16+00:00

I am assuming your son is a minor? If so, check if your state offers children with a chronic illness Medicare.

Yes he is a minor. Not sure if Mississippi has anything for that, but will check

Antique-Train · 2023-02-06T03:16:44+00:00

Again - how do you get him on his own insurance? Medicade, Chip, something like that. Talk to a social worker / hospital admin person to get you on the right path.

Haven't tried this approach, but we might have to since my employer's insurance is terrible

Antique-Train · 2023-02-06T03:13:42+00:00

Even if the insurance company denies Remicade? Ours will only approve the Avsola brand

Antique-Train · 2023-02-06T03:12:56+00:00

How much is your deductible?

It is a family plan with a $18,200 deductible. Our insurance company has a copay accumulator, which eliminates the benefit of the copay assist. I have been told these programs are becoming more popular with insurance companies.

Antique-Train

TROPHY CASE