Miss Migraine Gets Angry Part 2

Banner that says "The Adventures of Miss Migraine"

The Adventures of Miss Migraine is an ongoing column about my life with chronic migraine. A version of this post appeared first on my blog of the same name on December 19, 2012.

If you read Miss Migraine Gets Angry, you know that my insurance company tried to limit my access to triptans, and that I planned to follow through with them and correct their egregious money-grubbing behavior. (Oops, did I type that out loud?)

Unfortunately, I wasn’t entirely successful, partly because I’m currently unable to take triptans at all (more on that in another post). But my neurologist did send the insurance company an authorization for them to a.) cover Maxalt and b). give me the full 12 pills my prescription calls for.

A tower of pills

Insurance companies’ policies determine our level of access to health care.

While I was waiting for the authorization to go through, I called the FDA, and they directed me to information online proving that no, the FDA does not regulate insurance companies and that, yes, the recommended Maxalt dosing comes out to 12 10-mg. pills per month [Note: The page I had linked here doesn’t seem to exist anymore, and my lazy Googling did not come up with a ready replacement]. I emailed this to the insurance company with a polite, but firm, note. I never received a response, and they refused to let me speak directly with the pharmacy department. The woman I spoke with, while polite, seemed frustrated with my insistence.

So did it help? Has my insurance company changed its policies? Nope.

There’s one more step I can take, though. That’s to call the local branch of the National Association of Insurance Commissioners, an organization that helps protect the public’s interest when it comes to insurance of all kinds, including health. I’ve been too sick with migraines to do this (and the urgency isn’t there since I can’t take the pills), but I plan to after the holidays.

This issue goes beyond me. It’s an issue that affects all migraine patients. In the greater scheme, insurance companies that limit prescriptions of any kind affect not only all of us suffering from  chronic illnesses, but those suffering from acute illnesses as well.

(And as a foot note, the authorization did go through and was approved, but there was some kind of issue between the pharmacy and the insurance company. I didn’t bother figuring out what it was since I can’t take Maxalt now anyway, but let’s just say this has been anything but a smooth process.)

Has your insurance company tried to limit your medications? What steps have you taken?

 

Miss Migraine: Shopping for health insurance

Banner that says "The Adventures of Miss Migraine"

The Adventures of Miss Migraine is an ongoing column about my life with chronic migraine. A version of this post appeared first on my blog of the same name on September 6, 2012. I’ve updated it with reflections and more experiences.

When I was 26, my partner was laid off and we lost our health insurance. It was 2012, and the ACA exchanges weren’t up and running yet. So, I had to shop for health insurance on my own, to ask questions like “What kind of formulary does this plan have?” and “What would the prescription co-pays be for venlafaxine, topiramate, verapamil, Maxalt, Migranal?”

Caduceus and headlight

“Caduceus and Headlight” by Flickr user takomabibelot. Used under Creative Commons license.

I had to check and double check for things like spinal manipulations and mental/behavioral health coverage. I had to weigh specialist co-pays against deductibles and monthly premiums, generic prescription co-pays against brand-name prescription co-pays and mail order pharmacy co-pays.

At the time, a colleague of mine, similar age, same career goals (writer), said this to me: “Yeah, I had health insurance in grad school. It was a decent plan. But I never used it.”

I use my insurance at least once every week. To refill prescriptions, to see my chiropractor, my therapist, my migraine specialist. To get another test done. So many tests. Yearly blood work, at least, but throw in a nearly annual visit to the ER and we’re talking CT scan or MRI on top of that, which always come out of the deductible.

The specialist visit co-pays mean more to me than the regular office visit co-pays. I hardly even looked at that column. I see my PCP once or twice a year. I see my migraine specialist every three months. But even more important, it’s the prescription co-pays I have to watch out for. Right now a generic version of my abortive drug, almotriptan, costs me $80 for 12 pills. A generic.

My friends, my colleagues, most of them don’t even know what their specialist co-pays are. I’m painfully aware of mine. I envy them, my friends who look at health insurance as a bonus, an unnecessary extra.

In 2012, a health care plan for two people with a $5,000 deductible cost us $500 per month. Honestly I don’t know how we afforded it, except that we couldn’t afford not to. I’ve been on several different insurance plans since then, some good, some bad.

On each one, though, I’ve had to fight for the coverage I need. Migraine isn’t a deadly disease in most cases, but it can be deadly in indirect ways. It can make you so miserable you just want to find relief in any way possible. It can make you desperate. And health insurers? They don’t care. They are only thinking about the bottom line. The ACA didn’t change that. Sabotaging the ACA didn’t change that.

But you know what will? Universal health care. I’m not going to debate the ins and outs of it or exactly what form it should take. Greed is literally killing people. Universal health care won’t solve all the problems of our health care system, but it could save lives. I hope one day I can talk to a teenager and tell them the crazy story of how you used to have to shop for health insurance.

For now, though, it’s open enrollment season with our current insurance provider, and I need to get back to the books to figure out which plan will be the least frustrating.

 

Miss Migraine: A list of things that happen to me when I don’t sleep

Banner that says "The Adventures of Miss Migraine"

The Adventures of Miss Migraine is an ongoing column about my life with chronic migraine. A version of this post appeared first on August 13, 2012, on my blog of the same name.

My body is not adjusting well to venlafaxine (brand name Effexor), an anti-depressant also prescribed for migraine patients. I just. Can’t. Sleep. I started taking melatonin every night to help me sleep, and it does, but only enough so that I don’t go crazy.

A List of Things That Happen To Me When I Don’t Sleep:

  • Coffee. Normally, I only drink tea, and only in the morning. Coffee inevitably makes me feel icky and more headachey, but at least it wakes me up a little.
  • Drifting. Somehow I get from one place to another, but I never remember how I did it. Sometimes I think I turn into a ghost or momentarily disappear, or possibly become Shadow Cat from X-Men and start phasing through solid objects. That, or my sleep-deprived self has the ability to manipulate the time-space continuum.
  • Fangs. My filter disappears and everything gets on my nerves. I feel like I’m jumping out of my skin, like I’m the chalkboard and the world around me is made of nails. I snap at everyone and lose patience at everything.
  • Migraines. Ironic that the medication that’s supposed to be decreasing the frequency and severity of my headaches is currently increasing them because it’s preventing me from sleeping.
  • Dark circles. These happen to everyone, so at least I can feel normal about one thing.
  • Rambling when I don’t sleep I sometimes forget to use punctuation or that sentences and paragraphs exist and my brain moves slowly and I’m afraid to stop it because I’m not sure I will be able to start it again…
  • Delusions. While I’m drinking the coffee, I feel like I can do EVERYTHING. And then I start. The coffee runs out, and I forget what I was doing, or get distracted, or just give up. Which is why I’m going to end this blog post here, before I run out of coffee and forget what I’m supposed to be doing.

(I’m no longer taking venlafaxine, but now I’m on a different drug that’s basically doing the same thing. But it at least helps with the migraines, so…??)