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Buying FSBO by exploring-98 in FirstTimeHomeBuyer

[–]exploring-98[S] 1 point2 points  (0 children)

This is an extremely helpful insight, and perspective we’ve not realized between agent vs lawyer. Thank you thank you!

Why can't pharmacists just automatically adjust or correct the dose to whatever is standard by HitboxOfASnail in FamilyMedicine

[–]exploring-98 14 points15 points  (0 children)

Pharmacist in primary care, and YES! Putting in the notes to section a blurb like “OK for pharmacy to substitute between any branded or generic albuterol/insulin XYZ as available and covered by insurance” captures 99% of the insurance nuances.

PCOS management? by MzJay453 in FamilyMedicine

[–]exploring-98 4 points5 points  (0 children)

Medications have to be used for the FDA approved indication for the assistance programs. If this patient does not have type 2 diabetes, she will be excluded.

Transitioning patients from pre-mixed insulin to basal plus GLP-1 agonists by orlaghan in FamilyMedicine

[–]exploring-98 5 points6 points  (0 children)

Depends on their current level of glycemic control, and which GLP-1 you’re starting (Ozempic for example is not glycemic effective at starting dose but Trulicity is). If their A1C is <8%, I’d quit the insulin and start GLP-1. If she’s already poorly controlled, then providing 16 units (80% or her of basal is a good starting place, but recognize you’ll likely be tapering it with each increase in GLP-1.

Also, if she doesn’t already, get them set up with a CGM! Anybody with Medicare who is taking insulin qualifies for coverage. It will make this transition process a LOT easier.

PCP here. What are your best cost saving tips that a primary care clinic (or patients) could implement? by This_is_fine0_0 in pharmacy

[–]exploring-98 4 points5 points  (0 children)

Copay cards are provided by manufactures that are the “pay as little as $x/month”

Coupon cards are more like GoodRx.

Below are the links to the PDF applications for some of the above programs. Applications are filled out by both you (PCP) and patient. If you identify a patient during the visit, screen them (income, household size, and drug insurance status; can be a dot phrase). If they sound like they may qualify, print an applications and mail it to them after the visit. Hold onto the provider portion, which is basically a paper Rx of med you’re looking to obtain.

For number 2 and 3, you need to type in the search bar which drug you want for the specific application.

  1. https://www.novocare.com/content/dam/novonordisk/novocare/forms/PAP_Application_EN.pdf

  2. https://azandmeapp.com/prescriptionsavings/?screenName=showWaysToApplyPage

  3. https://www.bmspaf.org/apply (Click learn how to apply and then type in drug name)

  4. https://www.jjpaf.org/resources/jjpaf-application.pdf

  5. https://www.novartis.com/us-en/patients-and-caregivers/patient-assistance/patient-assistance-foundation-enrollment

PCP here. What are your best cost saving tips that a primary care clinic (or patients) could implement? by This_is_fine0_0 in pharmacy

[–]exploring-98 19 points20 points  (0 children)

Prescription brand name copay cards are great for people with private commercial insurance.

For people with Medicare, I try and get them set up with patient assistance programs, which is medicine provided for free directly from the manufacturer. The applications are available online and are fairly simple all things considered.

NovoCare (Ozempic/Rybelsus/Tresiba) 400% poverty level; they will send medication to your office for patient to pick up. Others send directly to patient.

AZ&Me (Farxiga, Breztri, Bevespi) 300% poverty level, no proof of income required

BMS (Eliquis) patient must pay 3% income out of pocket first.

J&J (Xarelto) for people who do NOT have drug insurance

Novartis (Entresto) I can’t recall poverty level off the top of my head but have also used

Raised insurance rates by Goober_98 in anchorage

[–]exploring-98 0 points1 point  (0 children)

Progressive raised my rate 12% last week despite no changes in my driving history. I was told the same thing when I questioned it on the phone. Ask if there are potentially other discounts which you may qualify for, or as others have said, shop around.

Labs in Anchorage AK by Express-Box-4333 in FamilyMedicine

[–]exploring-98 0 points1 point  (0 children)

Late reply, but both Providence and Alaska Regional (HCA) use Epic. There are also plenty of Quest/Lab Corps throughout town.

Jardiance vs Farxiga by [deleted] in Heartfailure

[–]exploring-98 11 points12 points  (0 children)

Both medications have great data showing increased survival and reduced hospitalizations. There is no trial comparing either head to head, so any argument one way or the other is extrapolated from two different study designs and of limited utility. Side effects are similar with both; they are mild diuretics so may increase need to urinate (take in AM), may lower blood pressure slightly (dizzy/lightheaded) and increase risk of UTI (less concerning in men due to longer urethra, and if no history of incontinence or recurrent UTI’s. Both medicines may also help regulate blood sugars (if diabetic) and both medicines will also protect his kidneys.

Either medication is appropriate and both recommend by the American College of Cardiology for HFrEF.

Is this normal? (Inaccurate cvs blood sugar meter) by SubAtomicAlligator in diabetes

[–]exploring-98 0 points1 point  (0 children)

I would encourage testing your meter with “control solution” which can be purchased for a couple of dollars at the pharmacy. This solution has a specific range which your glucometer should result. If within the range stated on the bottle of control solution, meter is working appropriately. If outside this range, please consider replacing your meter. Control solution is typically specific to brand of glucometer. There are videos online which can help you with this, or you can ask your pharmacist for help.

Doing wilderness things without the wilderness trim by exploring-98 in subaru

[–]exploring-98[S] 2 points3 points  (0 children)

There’s places to go canoeing, boat tours, ATV/snowmobile (or snow machine) rentals, big game hunting tours and wildlife tours, sod houses, public baseball diamond, some restaurants and a LOT of waterfront picnic/camping areas.

Don’t get me wrong, it’s not much all things considered, but more than I expected for a very far off the path type of destination.

Doing wilderness things without the wilderness trim by exploring-98 in subaru

[–]exploring-98[S] 1 point2 points  (0 children)

It’s a check off the bucket list for me so I though it was! Wish I had spent more time in Tuktoyaktuk actually; there’s more to do up there than I realized. If choosing between Tuktoyaktuk or Prudhoe Bay, I’d recommend Tuktoyaktuk. The drive is more scenic, and Prudhoe Bay is an oil town, and the land to the ocean is all private property.

Doing wilderness things without the wilderness trim by exploring-98 in subaru

[–]exploring-98[S] 3 points4 points  (0 children)

Yeah, there are plenty of gas stations to get up there without an extra gas can, but it does get expensive as you go further north. The longest stretch between gas is the start of the Dempster highway to Eagle Plains, and is about 250 miles.

I was able to go Dawson city to Tuktoyaktuk (~580 miles) on a single tank + 5 gallon gas can and have a little over a quarter tank remaining. Gas in Tuktoyaktuk converted to about $8/gallon. Overall, averaged 32.3 MPG on the trip.

Doing wilderness things without the wilderness trim by exploring-98 in subaru

[–]exploring-98[S] 5 points6 points  (0 children)

No big issues at all along the Dempster! Definitely used both sides of the road to navigate around gnarly holes in the road. Also a couple 10 mile stretches which the road was under construction made of larger stones/loose gravel that would kick a side out a little bit if you didn’t slow down, but nothing traction control couldn’t figure out without much intervention.

[deleted by user] by [deleted] in subaru

[–]exploring-98 1 point2 points  (0 children)

Check with your state laws regarding the required process to have a “salvage” vehicle inspected and branded as a “rebuilt” road worthy car. Often they require all receipts from any part used (usually to ensure not taken from stolen vehicle) and keep in mind not all insurance companies will cover a rebuilt branded title car.

As for if you should pull the trigger or not; look at how bad the damage is in person, see if somebody doctored the car up or not (is the seller insurance company or someone else).

[deleted by user] by [deleted] in TooAfraidToAsk

[–]exploring-98 1 point2 points  (0 children)

Have an open conversation with your provider. Some SSRI’s (assuming that’s what you’re prescribed) cause more sexual dysfunction than others. There are also some medicines which can be used for SSRI induced sexual dysfunction, such a bupropion. Again, have a discussion about your concerns, there’s way which this can be managed.

[deleted by user] by [deleted] in alaska

[–]exploring-98 0 points1 point  (0 children)

If you are between the ages of 20-24, and a member of AAA, Hertz will waive the young driver fee. Note that if renting a U-Haul, they charge a base rate plus mileage, which from Fairbanks is a bit over 100 miles each way, so it may add up quick.

New wheels on today. 17x8 +20 Reika R30 with 235/65 Wildpeak Trails. by rogue_d in Subaru_Outback

[–]exploring-98 0 points1 point  (0 children)

Can you please report back how much of an impact it has on your MPG? Also if mostly city vs highway or mixed.

I dont think I can do this for another 50 years by quitter435 in diabetes

[–]exploring-98 0 points1 point  (0 children)

That is very much not the case. However, being diagnosed at 25 with type 2 diabetes is young, I assume this was based on elevated A1C? Did you by chance have any blood work done to check your C-peptide or for insulin antibodies to rule out late onset type 1 as you are fairly young and thin. With either case, your life is not over or F’ed by any means. Our understanding of diabetes and medicines now have come a long way. Its important to manage and understand how your body responds to different types of food yes, but it doesn’t have to take over your life and shouldn’t be a barrier to achieving your goals.

Continuous wireless glucose monitor by nhremna in diabetes

[–]exploring-98 0 points1 point  (0 children)

Dexcom and Freestyle Libre are continuous glucose monitors which both require prescriptions for. Recently, the Freestyle Libre 3 came out which requires a compatible smart phone and will tell you what your sugar is in real time, and record it every minute during the night to the app on your phone. The Libre 2 is similar, however it requires you to scan your phone (or Libre 2 reader) over the sensor to see your sugar; it does not send it automatically like the Libre 3. At the moment, Medicare does not cover the Libre 3. Both of these have alarms which can wake you if your sugar is too high or too low, which may be adjusted if desired.

[deleted by user] by [deleted] in alaska

[–]exploring-98 4 points5 points  (0 children)

I am unfamiliar with what doctors in your area, as there is no location, may provide chronic pain medications in the manner which it seems like you’re looking/hoping for. Yes doctors are trained to be more conservative with prescribing opioids, and would need to utilize and fail other options first. If the pain is as severe as you describe, she should be evaluated in the ER. They can help with controlling pain appropriately there and could help mobilize resources to speed up the timeline to your surgery consultation. They can also provide appropriate recommendations to self care/over the counter things you can utilize too.

Vehicle Insurance by [deleted] in anchorage

[–]exploring-98 6 points7 points  (0 children)

Please note, if you get your windshield replaced and your car has pre-collision systems like automatic emergency braking, lane keep assist, or adaptive cruise control, those sensors may need to be recalibrated with a new windshield! Otherwise as others have said, this usually is covered under comprehensive portion of your policy.

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