Cancer Support

bmichaelh

(599 posts) Sun Aug 25, 2019, 05:28 PM Aug 2019

Sometimes employer paid health insurance is not that great

Currently, I am going through chemotherapy for lymphoma.

My doctor prescribed a drug to assist with my white blood counts.

Unfortunately, my employer uses a company that uses only one pharmacy for specialty drugs like this and it is taking them forever to fulfill the prescription.

The drug will not arrive in time this cycle so I will hope that I do not need it until the next cycle.

It has been six business days since the drug was prescribed.

So even though you may have insurance through your employer it does not always work like it should.

4 replies

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Sometimes employer paid health insurance is not that great (Original Post) bmichaelh Aug 2019 OP

that's just wrong Skittles Aug 2019 #1

Don't forget the 3k-5k deductible you have to eat before most employers start paying for anything. brush Aug 2019 #2

First find out if the implications of the delay. Ask your Doctor. still_one Aug 2019 #3

Is this Neulasta? PennyK Sep 2019 #4

Skittles

(159,240 posts)

1. that's just wrong

Reply to bmichaelh (Original post)

Sun Aug 25, 2019, 05:32 PM

Aug 2019

you should never have to wait or hope you don't need something

I wonder how this affects recovery, when people going through a tough medical situation have to be stressed out by insurance woes

I hope you will be OK......stick with us, bmichaelh, someone is ALWAYS here on DU

brush

(57,471 posts)

2. Don't forget the 3k-5k deductible you have to eat before most employers start paying for anything.

Reply to bmichaelh (Original post)

Sun Aug 25, 2019, 05:46 PM

Aug 2019

still_one

(96,521 posts)

3. First find out if the implications of the delay. Ask your Doctor.

Reply to bmichaelh (Original post)

Sun Aug 25, 2019, 06:09 PM

Aug 2019

Talk to your insurance company, and tell them you need the drug for this cycle, and you want expediated shipping. Get names. If the cannot obtain the drug because it is not available, and you MUST have it now for this cycle, and the insurance company will NOT give you a specific ETA, consider seeking out another pharmacy, and appealing later if the insurance company won't reimburse.

If your Doctor says breaking the cycle would be harmful, you have to be very aggressive, and maybe go out of that specialized pharmacy network. I am sure you have done this, but call that specialized pharmacy also, and see if there is anything that can be done to get it on time.

This is outrageous.

Take care

PennyK

(2,312 posts)

4. Is this Neulasta?

Reply to bmichaelh (Original post)

Wed Sep 4, 2019, 01:56 PM

Sep 2019

I would return the day after chemo to get it in a shot.

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