I've been "unwell" and now I am also angry!

I have been under the weather the past two weeks. I have had a continuous headache that I can't get rid of. I hate going to doctors but decided earlier this week I needed to. Earlier in the month I had the "crud"-a head cold with terrible sinus issues. With an antibiotic prescription to heal the sinus infection, I began to feel better.

Meanwhile, I received a letter from my health insurance provider in December, indicating that a medication I have taken for fours years for acid reflux was no longer going to be covered except as a Tier 1 drug; i.e, I will pay close to full price for this prescription. They are now going to provide Nexium, a drug that up until now they would not cover. Since my other prescription, Protonix, was no longer going to be covered, my physician wrote a prescript for Nexium the beginning of January. I began taking that at the first of the month. Three days after taking, I began having headaches, cough, stomach issues, etc. All of the known side effects. So, is my continuous headache due to sinuses or Nexium? Add to this stress from my job and newly imposed deadlines that in essence helped intensify my headache. Thus I am "unwell".

So I go to the doctor on Friday for the headaches and semi-vertigo issues. After an examination and additional discussion, the Nexium is not going to be good for me and my sinuses are still infected. So new medicine and treatment for sinus and a new prescription for my old medication. Of course my physician tells me that my insurance carrier, Anthem Blue Cross, will balk at this prescription and I will have to pay a higher price but my physician will present an appeal for the old medication. Sure enough, on the way to the pharmacy after leaving the doctor's office and running home momentarily, I get a call from the pharmicist saying that the insurance company will not cover the prescription and they suggest that I try Prevacid OTC or Nexium. In case you may not know, these drugs are from the same company with similar drug composition that my system does not like. I inform the pharmacist that I was anticipating this reaction and suggestion from Anthem but my physician has determined that this is not a suitable medication for me and thus they should fill the prescription and I will have to pay the full price while I await for an appeal decision.

Let me summarize to make this long rant shorter, I picked up my gold plated prescription which has served me well for four years!!!! and paid $102 for a 30-day supply when I use to pay $60 for a 90 day supply for the same medication!!!! The "moral" of this story is that my insurance carrier can and is being bought and paid for by big pharmaceutical company. To h--- with what the need of the patient is or consideration that the other drug may be more suitable for the patient since they have been taking it for FOUR YEARS. So an appeal has been registered by my physician but from hearing about others who have had to go through this for other medication, my insurance carrier will probably say no!!! This may be my new "cause" to push as this is just not right!

Since this is a blog about sewing how do I get this to relate. Well I just have not felt like sewing with not feeling well. So last night and this AM, I just read others blogs about sewing and visited fabric sites thinking about what I would make from the lovely fabrics I was seeing.

The sinus situation is starting to improve and this afternoon I spent about 1.5 hours in my sewing room working on the Vogue jacket. My intent this evening is to watch TV with DH and tomorrow do some sewing on the jacket as the sinus situation is showing some improvement and the headache is almost gone. Still a dull ache.

If you have had a similar situation with your insurance carrier and got the issue resolved in your favor, leave a comment.