To my surprise, I called to order my son's factor from the South Carolina Department of Health and Environmental Control (SCDHEC), as I have been doing for over the past year, and they tell me I can not get their factor from them anymore. I was told that I should be able to get factor from my insurance company and this was discovered when they went to submit the bill for the factor. This is news to me. I tried to get factor from my insurance company pharmacy and no one knew what hemophilia was or who to send me to to discuss what I needed.
To my luck and surprise this time I was only transferred around twice and a representative from CVS Caremark special pharmacy department was able to help me with no problem. After two weeks, I was approved and the factor was delivered and I also received a visit from a CVS Caremark Customer Relations representative.
I don't know whether to be relieved or disappointed in myself for not getting through to someone at Caremark the first time. I was fortunate enough to get both my sons set up on the free factor program and SCDHEC was great to deal with. I now have a $50 co-pay for each of my sons when I order factor, but all supplies are included. I know we are still fortunate because some people pay more than this. After further research, I noticed CVS Caremark advertisement on a Hemophilia of NC newsletter with the contact names and phone numbers of the individuals that are helping me now. Too bad I didn't read this newsletter before. I consider myself lucky that this transition was easy!
The random thoughts of a Mother dedicated to taking care of her sons with hemophilia, staying involved in the hemophilia community and continuing to learn about hemophilia.
Showing posts with label insurance. Show all posts
Showing posts with label insurance. Show all posts
Insurance Not Making It Affordable!!!
For the last 7 years I have had it easy being a Prophyholic HemoMom. My ex-husband had great insurance! When it was time for Marques (8) to get his port, I didn't think twice about it, getting his factor or at the time having nurses come out to the house....no problem, we paid nothing out of pocket. I knew not having "good" insurance was a problem for some hemophiliacs like my Dad, so I was grateful for the insurance my ex-husband had.
When I had Laithan and Layla (1) with my current husband, he did not have any insurance. He was working a temp to perm job at the time, so we were hoping he would get hired before I had the twins. Unfortunately, that didn't happen so I tried applying for Medicaid but was denied. Laithan's first few hematology appointments I still owe for today....Luckily, Baxter had a free sample program so we were able to get 6 doses of factor free. I just prayed we wouldn't need them or it would last us until we had insurance.
After some guidance from the Hematologist Clinic Social Worker, I was able to find a program in SC called the Child Rehabilitative Services (CRS). They provide free blood products and supplies to children with Hemophilia. When we were approved for that program, I was jumping for joy and proud of myself for researching, driving down to the health office, completing the paperwork and getting approved. Finally, when the twins were 7 months old my husband was hired permanently and we finally had insurance. The insurance now paid for the Dr. appointments, but I was still getting the factor through CRS.
After thinking, "okay I have this all under control!" My ex-husband has decided to move closer, which means that Marques no longer has the "good" insurance. My ex-husband job has a co-pay for the factor which will cost me about $200 month (so funny, UPS just rung the door bell to deliver it). Still, I know for some families they pay more than $200 month, but since I am now a stay-at-home Mom I don't know how to stick this $200 in our budget. However, I do know I can get his factor for free like Laithans. I will be going down to my County's CRS and adding him onto the application. I also now have a co-pay of $65 to see the hematologist verses the $10 and $130 emergency room co-pay verses $50.
Thank you to all the hemophilia health advocates, hemophilia associations and families that fight for these state programs!! I am now dealing with the true realities of how expensive being a Prophyholic HemoMom really is.
When I had Laithan and Layla (1) with my current husband, he did not have any insurance. He was working a temp to perm job at the time, so we were hoping he would get hired before I had the twins. Unfortunately, that didn't happen so I tried applying for Medicaid but was denied. Laithan's first few hematology appointments I still owe for today....Luckily, Baxter had a free sample program so we were able to get 6 doses of factor free. I just prayed we wouldn't need them or it would last us until we had insurance.
After some guidance from the Hematologist Clinic Social Worker, I was able to find a program in SC called the Child Rehabilitative Services (CRS). They provide free blood products and supplies to children with Hemophilia. When we were approved for that program, I was jumping for joy and proud of myself for researching, driving down to the health office, completing the paperwork and getting approved. Finally, when the twins were 7 months old my husband was hired permanently and we finally had insurance. The insurance now paid for the Dr. appointments, but I was still getting the factor through CRS.
After thinking, "okay I have this all under control!" My ex-husband has decided to move closer, which means that Marques no longer has the "good" insurance. My ex-husband job has a co-pay for the factor which will cost me about $200 month (so funny, UPS just rung the door bell to deliver it). Still, I know for some families they pay more than $200 month, but since I am now a stay-at-home Mom I don't know how to stick this $200 in our budget. However, I do know I can get his factor for free like Laithans. I will be going down to my County's CRS and adding him onto the application. I also now have a co-pay of $65 to see the hematologist verses the $10 and $130 emergency room co-pay verses $50.
Thank you to all the hemophilia health advocates, hemophilia associations and families that fight for these state programs!! I am now dealing with the true realities of how expensive being a Prophyholic HemoMom really is.
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