I am using Lidoderm patches or what I affectionitally call “pain patches” to control the discomfort that I have from my shoulder that I injured when I tipped over my motorized wheelchair in February. They are used 12 hours on and 12 hours off. They work really well. THe problem with them, is the cost. While I only have to pay $56 for 90 patches, which lasts me 90 days, the cost to my insurance company is $700. and that cost is deducted from my yearly allowable, of which I start with $2800. Once I use all that up, I am in what’s known as the ‘donut hole’ and have to start paying for things out of my own pocket, and although, all of my generic drugs would be paid for, it’s still going to cut into any drug that is not generic, and I don’t think the pain patches qualify.
I just wish my shoulder would settle down so I wouldn’t have to use the patches so then I wouldn’t have to worry about it, and could just go back to my normal oral medications, but while I’m in Physical Therapy, the pain is a bit more than I can stand. (Okay it’s more than a ‘bit’, that’s why the pain patches, but still…
Anyway, my allowable, would get me pain patches for the year, and that’s IT. It wouldn’t allow me any other drugs… but I still need oral medications. I’m not sure how much my prescip9iton medicaitons run, but it’s not the amount that I pay that is calculated, it’s the full cost. say you pay $4 for a prescription, but your insurance pays $200. Well, if that happens for me, the full cost of $200 would be charged against my allowable. Sucks, doesn’t it? I’ve only hit the ‘donut hole’ and that was last year, but that year I was on a plan that didn’t cover as much as the plan this year.
I decided to pay more in premiums this year, so I was covered. I am paying $100 more a month, but all big ticket items will be covered like a new wheelchair, which is one thing that I am getting this year. My current wheelchair is 10 years old, and they usually replace them every five years. Well, I paid for this wheelchair as a private pay. That means I bought it and didn’t charge it to insurance. It was only 3 months old when I bought it. when I went to Florida and bought it from my partner Fred Shotz way back in 1999. Fred didn’t like it because it had a hard seat and a hard back but that was required for the ’tilt and space’. He bought it from a gentleman’s estate and the chair was brand new. Well, Fred sold it to me for what he paid for it, and he got it for a steal. I flew down to Florida, minus wheelchair because I was picking one up, and just took myself and Gillis (my Doberman). And stayed a week. Had a blast.