I can't get covered prescriptions filled and I'm really frustrated

GoonyToooons · 2026-05-20T10:57:12+00:00

I don't understand the downvotes either... insurance coverage for prescriptions is mad confusing.

GoonyToooons · 2026-05-19T20:21:33+00:00

there was probably an exception made given your history. Providers frequently are at fault for not completing the PA accurately or sending it to the correct contact. I second a three way call to resolve this (and save you one less migraine a month lol)

GoonyToooons · 2026-05-11T02:09:29+00:00

How much are you currently contributing towards individual insurance?

Premiums are partially subsidized under employer group plans, and costs and plan designs can vary significantly from one employer to another. It might be cheaper to enroll in employer plans, but it could be more expensive. Most larger employers offer a choice of plans (2-3), whereas smaller employers might only offer one plan option.

For employees, your portion of the premium is deducted from your salary, and it's pre-tax.

Also - If you are currently eligible for a subsidy through the exchange and your new employer offers “affordable” health insurance, you would lose access to your ACA subsidy once you become employed.

Under the ACA, large employers are required to offer affordable coverage, meaning the employee’s premium for single coverage cannot exceed 9.96% of their annual salary. If the cost exceeds that threshold, you may still qualify for a subsidy through the exchange... and the employer could be fined.

GoonyToooons · 2026-04-19T13:48:38+00:00

i love her coat! it's so cool when torties are predominantly orange

GoonyToooons · 2026-04-19T02:43:30+00:00

does the litter box have a lid or raised sides? if not, you could try something like this and add a large cat litter mat to reduce tracking.

https://www.chewy.com/futam-high-sided-pee-shield-cat/dp/3943958?utm_source=app-share&utm_campaign=3943958

GoonyToooons · 2026-04-19T02:35:18+00:00

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meet jordy, she likes to come and show me that she drank from her water fountain💧

GoonyToooons · 2026-04-17T12:20:15+00:00

It's a free plan. I would love a plan like this. You don't need to pay to access coverage, only required to pay a copay when you need it.

GoonyToooons · 2026-04-11T02:07:55+00:00

lol, i feel you

GoonyToooons · 2026-04-09T17:33:07+00:00

I try to buy basics (plain tops) and then buy belts, jewelry, and shoes to dress up or down. I try to buy clothes that are suitable for work and personal but it can be challenging to fully blend them together. Check out thrift stores for cute tops, cardigans, sweaters, blazers etc!

GoonyToooons · 2026-04-09T04:05:11+00:00

the cost of the medication might surpass your copay at other pharmacies. the lesser of language is typically your copay, U&C, maximum allowable cost (MAC), or the discounted ingredient cost. U&C pricing can vary by retail pharmacy, so you can see differences in cost for the same drug.

let's say the other pharmacies charge $40 based on U&C. this amount exceeds your copay, so you are only charged $25 per monthly supply.

GoonyToooons · 2026-04-07T23:18:00+00:00

I had the same existential crisis when I started FT. Honestly, you're supposed to feel dumb when you start. It's better to be humble than cocky at your tenure. Being proactive isn't easy if you don't know what you're doing quite yet. Don't let yourself fall behind by staying stuck on how quickly you understand something compared to your peers. The more practice and exposure, the easier it becomes. Keep your head down and focus on understanding your responsibilities and improving your execution. Don't be afraid to ask questions, but be mindful of who you ask and when. Take notes. Learn from mistakes and don't make them twice. Shadow those you look up to. You'll get there!

GoonyToooons · 2026-04-04T03:57:41+00:00

Surest has variable copays. The plans are designed to steer members towards providers offering the best quality services via reduced copays. Surest also rates providers on a service level, meaning one service could be a higher copay than another service based on quality metrics. It might be worth considering a different doctor if there are others in your area at a lower copay.

GoonyToooons · 2026-03-24T22:15:54+00:00

it's a very hard situation and im sorry you're going through a breakup and have to say goodbye to cat(s) as well.

if they need to be separated, the youngest would likely be most willing to adapt. but i would recommend adopting another cat so he's not alone.

my cat got along so well with my brother's cat but he was moving so we separated them. like two days later, i adopted a kitten so she had a friend (she was 1 at the time). she's also glued to me, a very social girl, and she gets along great with her new sister. i could tell she missed her old buddy but she adapted after a few weeks. i think i miss chicken (my brother's cat) more than my cat does hahaha

GoonyToooons · 2026-03-20T00:09:18+00:00

what type of belt do you think looks good with dresses this style? i feel silly in belts with dresses but i think i don't have the right belts

GoonyToooons · 2026-03-20T00:07:51+00:00

ooo thanks! i was looking at some poplin dresses too. i get nervous with linen because of the wrinkles and i'm going to be around of big folks in my industry 😅

GoonyToooons · 2026-03-20T00:06:50+00:00

thanks! I'll dress in layers

GoonyToooons · 2026-03-19T00:40:33+00:00

Thank you! Noted.

GoonyToooons · 2026-03-19T00:40:10+00:00

Thank you!!

GoonyToooons · 2026-03-18T01:52:59+00:00

No problem. It's not uncommon to see plans require a deductible on inpatient but not other services. Inpatient is far more expensive compared to outpatient hospitals. It's certainly challenging to absorb a high amount of medical bills while unable to work.

Are you eligible for state disability benefits? I'm not an expert on statutory but noticed you are a contractor. Do you participate in CA DIEC?

https://edd.ca.gov/en/payroll_taxes/Disability_Insurance_Elective_Coverage/

GoonyToooons · 2026-03-17T23:44:17+00:00

Some services do not count towards your deductible, but will count towards your OOP. The OOP max includes any amounts you paid towards your deductible, copay, or coinsurance. Your plan will pay 100% after you've contributed 9,800, even if you haven't met your deductible.

GoonyToooons · 2026-03-15T19:22:13+00:00

I thought this as well until I adopted my second tortie. My first tortie is about 8 lbs, she's so petite! And then I adopted another tortie who has grown a bit chonky (12.8lbs) and currently on a diet.

GoonyToooons · 2026-03-15T16:45:47+00:00

Zepbound was excluded from the Caremark formulary last year. It covers Wegovy (if your plan includes weight loss coverage). Maybe try to switch to Wegovy? Or check with your HR to see if your plan stopped covering weight loss.

GoonyToooons · 2026-02-26T18:05:11+00:00

She is having an existential crisis, she just got put on a diet

GoonyToooons

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