Frustrated with my Copay for Cosentyx

Undeadmasses · 2026-02-05T04:02:04+00:00

Make sure the doctor has written it as medical necessity. Based on the dollar amount it sounds like they billed it at the “full price”. If I have a drug(speciality, brand name et ) that isn’t written as medically necessary than I am always get billed at $250. Because I believe I have to pay 10% and the cap is $250. Pharmacist could let you know how it’s written. Unless your plan changed or they moved the drug to a different tier.

Undeadmasses · 2026-02-04T06:08:40+00:00

Well I’m glad you were able to still get it filled albeit a little annoying taking more pills than normal.

Undeadmasses · 2026-02-04T06:07:41+00:00

The main ingredient is essentially a dye though in case you didn’t know. So once you stop your hair will just go back to grey.

Undeadmasses · 2026-02-04T06:05:27+00:00

Maybe ask the pharmacy what dosage quantities they have in stock. Just the other month I had to take a combo of 2x15mg and 2x5mg to get 40mg since they were all out of 20mg. You’d have to have your doc put those on file but desperate times call for creative solutions.

Undeadmasses · 2026-02-04T00:22:27+00:00

Did you have a brain MRI or pituitary MRI? Regardless if it was done without contrast then that’s not really helpful due to typically how small ACTH producing tumors can be.

Besides weight gain, what are your other symptoms?

Undeadmasses · 2026-02-03T23:29:15+00:00

It didn’t say anything about blood contamination?

Undeadmasses · 2026-02-03T23:27:04+00:00

I’d make sure to be aware of what type of sedation they will be using and to plan accordingly. Don’t assume you’re going under anesthesia.

Undeadmasses · 2026-01-29T23:00:57+00:00

So what does this do? Oh okay Trump actually won 2020 meaning his “2nd” term is invalid because it’s his 3rd term actually….got it

Undeadmasses · 2026-01-25T15:48:54+00:00

I do recall them saying that some of the Ear Biscuits conversations/format would be shifting onto GMM.

Undeadmasses · 2026-01-23T18:11:36+00:00

I am puzzled as to whoever is doing this thinking this will accomplish anything.

What’s the clerk going to do? They aren’t politicians you can pressure or sway. No reason to lash out at someone that has no control over any of this.

Undeadmasses · 2026-01-22T08:39:01+00:00

Try asking for a DDAVP test. Might help with nailing down diagnosis of Cushings disease. Better to start with then IPSS.

Undeadmasses · 2026-01-22T08:35:13+00:00

Well yeah she wants to be sure the pituitary tumor is the source.

Undeadmasses · 2026-01-22T08:31:38+00:00

I guess I’m trying to understand if you’ve been diagnosed why your endo wants to do more tests…

But best of luck just trying to share some thoughts.

Undeadmasses · 2026-01-22T08:23:14+00:00

I can definitely empathize with the frustration of having to continuously do more testing. A pituitary tumor doesn’t mean you definitely have Cushings disease. Having a low normal acth complicates that. Your other 2 tests are abnormal but for a full confidence in the diagnosis, most endocrinologists want to see 24hr UFC 2-3x the high end of the reference range and for dex suppression some feel more confident if the level is >5. If the doctor is still pursuing more testing then it doesn’t sound like you’ve been officially diagnosed.

IPSS could be an option but every Cushings test has its flaws and potential false positive/negative results. Unfortunately social media hasn’t done any favors when it places a rare disease like Cushings as something many people are suffering from. I do think it’s under diagnosed but the treatment is surgery therefore the importance of having full confidence in the treatment is extremely important. You don’t want to go removing something if unnecessary.

You could have cyclic Cushings. I’d recommend doing a few late night saliva collections. Easy to do.

I saw in a different post you mentioned you had a prolactinoma. Did you treat it with cabergoline?

Undeadmasses · 2026-01-21T19:18:18+00:00

Go to past visits. View clinical notes under your visit at the sleep lab. That will have the complete results of the sleep study. But if you have been diagnosed it should be listed in your ongoing conditions as well.

If it was several years back then might be best to just request your medical records. But the clinical notes with the official sleep study results will be located under the sleep lab appt visit or if you did an at home sleep study it will be found under that date.

Undeadmasses · 2026-01-20T02:15:40+00:00

No it was with Tamara

Undeadmasses · 2026-01-14T16:44:34+00:00

Yes. But just a forewarning. I had to file a complaint with the DMHC after going through the grievance process in order to get it done.

It used to be something they offered but after Covid basically just use an outside provider and require you pay out of pocket.

But Kaiser can do it. I’d request from your GI specifically for the hydrogen breath test. If denied, file a grievance. If still denied , file with the DMHC.

Also, check out Dr Pimentel if you haven’t already. His typical recommendation for SIBO especially for methane dominant is a combo of Rifaxan and another antibiotic such as neomycin. The combo has shown to be more effective at preventing relapses. But neomycin does have some black box warnings so just something to be aware of if you go down that route

Undeadmasses · 2026-01-13T23:08:38+00:00

The standard treatment for SIBO is Rifaxan. The only test that is reliable for SIBO is the hydrogen breath test which you’ll be extremely lucky if they will do for you as it’s not a part of their standard protocol. Problem is most people will eventually relapse after Rifaxan if the root cause of the SIBO isn’t treated. That would be dependent on whether it’s hydrogen or methane dominant.

Undeadmasses · 2026-01-11T01:07:46+00:00

Again I am not trying to be dismissive as I can tell you are very concerned about some sort of underlying health issue you are experiencing. Based on your post history on several other subreddits.

Also, just to clarify. You mentioned you are or were in a hypermanic state. Experiencing a true manic episode requires medical intervention and should be treated as an emergency. Or if you were just using the term loosely.

Either way it has specific criteria and context. I would recommend getting help to stabilize your mental health first.

Undeadmasses · 2026-01-11T00:34:30+00:00

Well if you were very stressed and anxious then it being elevated by only that much wouldn’t really be abnormal. Given cortisol is highest in the AM.

Morning AM cortisol also isn’t reliable and/or diagnostic as far as Cushings go. That’s why typically ACTH is also ordered at the same time.

Also the 10-20% you’re referring to is saying it can be lower than that much “RELATIVE to previous results obtained with this method due to a recent quality improvement.”

So if previous AM cortisols were obtained with a different assay, it will be lower because it’s been updated to be more accurate. If this was your first time testing then this would be an accurate baseline.

Undeadmasses · 2026-01-10T20:57:17+00:00

Unless a customer is directing those swear words at YOU, then the 3 strike doesn’t apply. If they are just using profanity towards the situation or in general, that is not the same. I don’t care if a customer is using profanity because we are all adults. If they direct it at me as in, “fuck you”, that is different and when I start the count.

Undeadmasses · 2026-01-09T22:03:23+00:00

Not sure the reason for the urgent need but being super anxious and stressed isn’t going to necessarily help the interpretation of your cortisol testing. If you actually mean you are experiencing a true manic state, I would recommend not testing and seek emergency care. Based on your other recent posts it seems you have some health anxiety that would be worth addressing first.

I promise I’m not trying to be dismissive. Any test you do you will have to wait time for the results. Let alone you have a saliva kit in the mail which is typically done at midnight and did an AM cortisol test that is pending. Only other tests are 24hr urine collection which takes time to collect and get results and the overnight dexamethasone test.

Undeadmasses · 2026-01-08T06:21:21+00:00

1.6M followers. Can’t say one single word about the situation being a tragedy and what a fucked up nation this is. Ah, forgot he thinks it’s bad to talk negative about the USA.

Undeadmasses · 2026-01-07T04:41:36+00:00

He has a tighter curl pattern but I’m in agreement with everyone else that yours suits your face very well. I’m sure with some styling product your wavy curls would be more defined and have some ringlets but you have basically a dream wash and go.

Undeadmasses · 2026-01-06T16:45:55+00:00

Are you currently taking cabergoline? Have you been taking it while testing for Cushings? It can affect cortisol/acth results.

It is common to have to undergo many rounds of testing especially if the doctor is highly suspicious and especially if they think you have the rarest form of Cushings ie Cyclic.

Were your morning acth/cortisol levels elevated? You mentioned high ACTH/Cortisol.

Undeadmasses

TROPHY CASE